Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France.
Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France.
J Craniomaxillofac Surg. 2024 Feb;52(2):170-174. doi: 10.1016/j.jcms.2023.10.002. Epub 2023 Oct 14.
This study aimed to assess the efficacy of utilizing the internal jugular vein (IJV) as the primary recipient site for venous anastomoses in head and neck oncological reconstruction. Patients who underwent a free flap reconstruction of the head and neck were retrospectively included. Venous anastomoses were preferentially performed less than 1 cm from the IJV, either end-to-side (EtS) on the IJV, or end-to-end (EtE) on the origin of the thyrolingofacial venous (TLF) trunk. When the pedicle length was insufficient to reach the IJV, anastomoses were performed EtE to a size-matched cervical vein. Of the 246 venous anastomoses, 216 (87.8%) were performed less than 1 cm from the IJV, including 150 EtS on the IJV (61.0%), and 66 EtE on the TLF trunk (26.8%). Thirty veins (12.1%) were anastomosed EtE on other cervical veins more than 1 cm from the IJV. Two venous thromboses occurred (0.9%) and were successfully managed after revision surgery. There was no evidence of an increased thrombosis rate in high-risk or pre-irradiated patients. These findings suggest that the internal jugular vein is safe and reliable as a first-choice recipient vessel for free flap transfers in head and neck oncological reconstruction.
本研究旨在评估将颈内静脉（IJV）作为头颈部肿瘤重建中静脉吻合的首选接受部位的疗效。回顾性纳入接受游离皮瓣重建头颈部的患者。静脉吻合术优先在距 IJV 小于 1cm 处进行，包括在 IJV 上进行端侧吻合（EtS）或在颈袢静脉（TLF）主干的起点进行端端吻合（EtE）。当蒂长不足以到达 IJV 时，进行 EtE 吻合到与颈静脉匹配的大小。在 246 个静脉吻合中，216 个（87.8%）在距 IJV 小于 1cm 处进行，包括在 IJV 上进行 150 个 EtS（61.0%）和在 TLF 主干上进行 66 个 EtE（26.8%）。30 条静脉（12.1%）在距 IJV 大于 1cm 处进行 EtE 吻合到其他颈静脉。发生了 2 例静脉血栓形成（0.9%），经修正手术后成功处理。高危或放疗前患者的血栓形成率没有增加的证据。这些发现表明，颈内静脉作为头颈部肿瘤重建中游离皮瓣转移的首选接受血管是安全可靠的。
