当科統計による両側同時頚部郭清術の検討

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From 1976 to 1989, 51 patients with squamous cell carcinomas of the head and neck underwent simultaneous bilateral neck dissections, 19 had secondary contralateral neck dissections, and 169 had unilateral neck dissections at the Department of Otolaryngology, Asahikawa Medical School.The indications for simultaneous bilateral neck dissection were categorized into six groups: I, clinically palpable bilateral nodes; II, primary lesions large enough to suggest bilateral neck metastasis; III, development of bilateral neck masses during preoperative treatment; IV, recurrence of primary lesions with doubtful neck metastasis; V, large ipsilateral lymphnodes suspicious of contralateral metastasis; VI, technical convenience for reconstructive procedure and/or the patient's general condition.According to the TNM classification, the coincidence of N and pN was 25.5% in the simultaneously operated group, although 39.2% of them had bilateral neck metastase. The most common cause of death was distant metastasis to lungs or bones. Gontralateral neck dissection was performed secondarily in 19 of the 188 patients treated with unilateral neck dissection.Postoperative complications were mainly venous stagnation and neurological dysfunction. Bilateral ligation of the internal jugular veins was not related to these complications.The results suggest that more than two-thirds of patients with squamous cell carcinoma of the head and neck can be treated with unilateral neck dissection and that simultaneous bilateral neck dissection is justified in selected cases.
耳鼻咽喉科臨床学会の論文

当科統計による両側同時頚部郭清術の検討

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