多功能保留颈淋巴结清除术的应用

APPLICATION OF MULTIFUNCTIONAL CONSERVATIVE NECK DISSECTION IN HEAD AND NECK SURGERY

目的：在彻底切除肿瘤的前提下，研究实施一种旨在最大限度提高患者术后生存质量的颈淋巴结清除术。方法：天津医科大学肿瘤医院头颈科３ 组１９９２ 年５ 月～１９９８年１０ 月间收治的甲状腺分化良好型癌患者５３ 例。保留耳大神经５５ 例次，枕小神经３９ 例次，锁骨上皮神经外侧支３６ 例次，颈横动静脉３２ 例次。结果：全部患者术后１～３ 个月颈、枕部皮肤感觉恢复正常；患者术后无颈部肿瘤复发。结论：实施多功能保留颈淋巴结清除术可达到与目前常用术式相同的治疗效果，而患者术后生存质量明显提高。

Objective: Designing a method and founding a more effective way to improve the patients' life quality after the neck dissection(ND). Methods: The authors report their experience and surgical treatment of 53 patients with well-differentiated carcinoma of thyroid from 1992 to 1998 in the group Ⅲ of Head & Neck Department, Tianjin Medical University Cancer Center. On all of these patients was performed multifunctional conservative neck dissection (MCND). Results: Overall, there were no recurrence of disease associated with MCND. The functions of these nerves would be recovered in 1 to 3 months after operation. Conclusion: On the base of what has been allowed the removal of both the original tumor and the possible lymphatic metastases, MCND is more effective and practical than traditional and functional ND. The author recommend more frequent use of this technique in the Head & Neck surgical practice.