Dulguerov P, Soulier C, Maurice J, Faidutti B, Allal A S, Lehmann W
Department of Otolaryngology-Head and Neck Surgery, Geneva University Hospital, Switzerland.
Laryngoscope. 1998 Nov;108(11 Pt 1):1692-6. doi: 10.1097/00005537-199811000-00019.
To describe and evaluate the functional and oncologic results of one internal jugular vein replacement after bilateral radical neck dissection (RND).
A retrospective historical cohort study.
Since 1972 all patients (n = 9) undergoing bilateral RND with resection of both internal jugular veins had a reconstruction of one internal jugular vein. In six cases the RNDs were staged, and in three cases the RNDs were performed simultaneously. In every case a vascular reconstruction was performed with an autologous vein graft. All patients received radiation therapy, in five patients before and in four patients after the vein grafting. Functional results were evaluated in terms of postoperative head and neck and neurologic complications. In some patients a Doppler scan was performed to assess vein patency. Oncologic results are reported as relapse-free survival and mortality intervals.
In all patients the postoperative course was uneventful, without neurologic complications. Facial edema was noted in four patients, mild in three and moderate in one. Two patients are alive, with follow-ups of 8 and 18 years. Seven patients are dead, two without evidence of recurrence, four with cervical recurrence after a mean survival of 10 months, and one after distant metastasis after a survival of 7 years. In patients with long-term survival a Doppler scan confirmed the patency of the vein graft.
The lack of operative complications and the absence of postoperative neurologic complications make a unilateral internal jugular vein replacement after bilateral RND attractive, although the oncologic results remain poor.
描述并评估双侧根治性颈清扫术（RND）后一侧颈内静脉置换的功能及肿瘤学结果。
一项回顾性历史队列研究。
自1972年以来，所有接受双侧RND且双侧颈内静脉均被切除的患者（n = 9）均进行了一侧颈内静脉重建。6例RND分期进行，3例同时进行。每例均采用自体静脉移植物进行血管重建。所有患者均接受了放射治疗，5例在静脉移植前，4例在静脉移植后。根据术后头颈部及神经并发症评估功能结果。部分患者进行了多普勒扫描以评估静脉通畅情况。肿瘤学结果报告为无复发生存期和死亡间隔。
所有患者术后过程平稳，无神经并发症。4例患者出现面部水肿，3例轻度，1例中度。2例患者存活，随访时间分别为8年和18年。7例患者死亡，2例无复发证据，4例平均生存10个月后出现颈部复发，1例生存7年后出现远处转移。长期存活患者的多普勒扫描证实静脉移植物通畅。
尽管肿瘤学结果仍然较差，但双侧RND后单侧颈内静脉置换缺乏手术并发症且无术后神经并发症，这使其具有吸引力。
