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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Upper neck (level II) dissection for N0 neck supraglottic carcinoma.
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Upper neck (level II) dissection for N0 neck supraglottic carcinoma.

机译：N0颈部声门上癌的上颈（II级）解剖。

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OBJECTIVES: Elective neck dissection for the N0 neck in head and neck surgery is still controversial. This prospective nonrandomized study of N0 supraglottic carcinoma was designed to find an appropriate method of neck management. STUDY DESIGN: Anatomical studies show that the first echelon of lymphatic drainage from the supraglottic larynx is toward the upper jugular nodes (level II). An upper neck dissection (UND) was applied and all the lymph nodes were sent for frozen section. If the subclinical metastasis was found, a modified neck dissection was performed. If the nodes harbored no foci of cancer, the patients were observed after surgery on the supraglottic lesions. METHODS: Patient records of 142 patients with supraglottic laryngeal cancer (T1-4N0M0) were reviewed, with special attention paid to neck recurrences and survival rates. The cases were treated between 1976 and 1990 and all were observed for at least 5 years after the operation or until the time of death. RESULTS: The UND specimens of 142 patients were negative for metastasis. The 5-year survival rate for this group after surgery was 80.8%, according to the life table analysis. Fifteen of the 142 patients (10.6%) had neck recurrences during the period of observation within 5 years. The recurrence rate of this series with limited dissection on the neck was comparable with those reported in the literature after neck dissection, either radical or modified. CONCLUSIONS: There is no need for a comprehensive neck dissection for N0 supraglottic laryngeal cancer. A selective neck dissection such as UND (level II) or a supraomohyoid neck dissection (sparing the submandibular region) of level II and III will serve the purpose of radical neck treatment for the supraglottic cancer.
机译：目的：头部和颈部手术中N0颈部的选择性颈淋巴清扫术仍存在争议。这项关于N0声门上癌的前瞻性非随机研究旨在寻找合适的颈部处理方法。研究设计：解剖学研究表明，从声门上喉的淋巴引流的第一梯队是朝着颈上淋巴结（II级）。应用上颈清扫术（UND），并将所有淋巴结送去冷冻切片。如果发现亚临床转移，则进行改良的颈淋巴清扫术。如果淋巴结未见癌灶，则在手术后观察声门上病变。方法：回顾了142例声门上喉癌（T1-4N0M0）患者的病历，特别注意颈部的复发率和生存率。这些病例在1976年至1990年之间接受了治疗，并且在手术后或死亡之前至少观察了5年。结果：142例患者的UND标本为转移阴性。根据生命表分析，该组患者术后5年生存率为80.8％。 142名患者中有15名（10.6％）在5年内的观察期内出现颈部复发。颈部有限解剖的该系列的复发率与颈部解剖后的文献报道的根治性或改良性复发率相当。结论：N0声门上喉癌无需进行全面的颈部解剖。选择性的颈部清扫术，例如UND（II级）或II和III级的舌骨上舌骨清扫术（保留下颌下区域）将用于根治性声门上癌的治疗目的。

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