Weber P C, Johnson J T, Myers E N
Department of Otolaryngology, University of Pittsburgh, Eye and Ear Institute, PA 15213.
Arch Otolaryngol Head Neck Surg. 1993 Jan;119(1):61-4. doi: 10.1001/archotol.1993.01880130063008.
Previously reported data from our institution has led us to perform bilateral neck dissections for therapeutic as well as staging advantages for horizontal supraglottic laryngectomies. Concern over the possibility of increased morbidity associated with simultaneous bilateral neck dissection prompted this retrospective review of patients with supraglottic laryngectomy who were treated with either unilateral (46 patients) or bilateral (23 patients) neck dissection. No significant differences were found in morbidity when patients were evaluated for transfusion rate, cervical wound drainage, need for tracheotomy, oral diet, or duration of hospitalization. Significant differences were noted in surgical operating time, eg, it took 100 minutes longer to perform bilateral dissections, and slight increases were noted in estimated blood loss and fluids given intravenously. No significant differences were noted in the percentage or type of postoperative complications. It seems that bilateral neck dissection in conjunction with supraglottic laryngectomy does not increase postoperative surgical morbidity and may actually avoid complications associated with postoperative radiation therapy in patients with supraglottic laryngectomy.
我们机构之前报告的数据促使我们对声门上水平喉切除术患者进行双侧颈部清扫，以获得治疗及分期方面的优势。由于担心同期双侧颈部清扫可能会增加并发症发生率，我们对接受单侧（46例患者）或双侧（23例患者）颈部清扫的声门上喉切除术患者进行了这项回顾性研究。在评估患者的输血率、颈部伤口引流情况、气管切开需求、经口饮食或住院时间时，未发现并发症发生率存在显著差异。手术操作时间存在显著差异，例如，双侧清扫手术时间要长100分钟，估计失血量和静脉补液量略有增加。术后并发症的百分比或类型未发现显著差异。似乎声门上喉切除术联合双侧颈部清扫不会增加术后手术并发症发生率，实际上还可能避免声门上喉切除术患者术后放疗相关的并发症。
