颈部肿瘤手术涉及颈动脉的治疗体会

Treatment experience of neck tumor surgeries involving carotid artery

目的:探讨颈部肿瘤手术中对于颈动脉病变的手术处理方式。方法:回顾性分析兰州市第一人民医院肿瘤外科2010年3月-2020年5月治疗的5例颈部肿瘤手术中颈动脉处理的临床资料。分别采用颈动脉切除并结扎,肿瘤受累动脉切除并血管重建,肿瘤剥离及颈动脉破裂口修补的手术方式。结果:5例患者均手术成功。其中颈动脉结扎1例患者术后出现间歇头晕、对侧肢体肌力下降。其余患者无神经系统并发症。颈部低度恶性肌纤维母细胞肉瘤1例患者术后8个月出现肺转移。甲状腺乳头状癌颈淋巴结转移1例患者术后24个月出现肺转移。结论:目前临床处理病变颈动脉的手术方式有颈动脉切除并结扎,单纯肿瘤剥离,肿瘤受侵动脉切除并血管重建以及介入治疗。每种手术方式都有各自的优缺点,具体选择何种治疗方法取决于患者的具体病情、医师临床经验及设备条件。

Objective:To investigate surgical treatment of carotid artery diseases in neck tumor surgery.Methods:A retrospective analysis of the clinical data on carotid artery treatment was conducted in the five cases of neck tumor surgeries treated at Department of Surgical Oncology,the First Peoples Hospital of Lanzhou from March 2010 to May 2020.Surgical methods,including carotid artery resection and ligation,tumor-involved artery resection and vascular reconstruction,and tumor peeling and carotid rupture repairing were used,respectively.Results:Five cases were successfully operated on.One case of carotid artery ligation was followed by intermittent dizziness and decreased contra-lateral limb strength after the surgery.The remaining patients exhibited no neurological complications.A patient with cervical low-grade myofibroblastoma developed into lung metastases 8 months after the surgery.Another patient with cervical lymph node metastases in papillary thyroid cancer developed into lung metastases 24 months after the surgery.Conclusion:Currently,surgical methods for clinical treatment of diseased carotid arteries include carotid artery resection and ligation,simple tumor peeling,tumor invasion artery resection and vascular reconstruction,and interventional therapy.Each surgical method has its own advantages and disadvantages.Therefore,the choice of treatment depends on the patient's specific conditions,physician's clinical experience,and the equipment available.