颈部肿瘤手术涉及颈动脉的治疗体会

王梓年, 李静喆, 何玉奇, 等. 颈部肿瘤手术涉及颈动脉的治疗体会[J]. 临床耳鼻咽喉头颈外科杂志, 2023, 37(7): 570-574. doi: 10.13201/j.issn.2096-7993.2023.07.011
引用本文: 王梓年, 李静喆, 何玉奇, 等. 颈部肿瘤手术涉及颈动脉的治疗体会[J]. 临床耳鼻咽喉头颈外科杂志, 2023, 37(7): 570-574. doi: 10.13201/j.issn.2096-7993.2023.07.011
WANG Zinian, LI Jingzhe, HE Yuqi, et al. Treatment experience of neck tumor surgeries involving carotid artery[J]. J Clin Otorhinolaryngol Head Neck Surg, 2023, 37(7): 570-574. doi: 10.13201/j.issn.2096-7993.2023.07.011
Citation: WANG Zinian, LI Jingzhe, HE Yuqi, et al. Treatment experience of neck tumor surgeries involving carotid artery[J]. J Clin Otorhinolaryngol Head Neck Surg, 2023, 37(7): 570-574. doi: 10.13201/j.issn.2096-7993.2023.07.011

颈部肿瘤手术涉及颈动脉的治疗体会

详细信息

Treatment experience of neck tumor surgeries involving carotid artery

More Information
  • 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。
  • 加载中
  • 图 1  肿瘤包绕颈动脉(箭头所示为颈动脉)

    图 2  ePTFE人工血管重建(箭头示ePTFE人工血管)

    图 3  MRA示颈动脉体瘤

    图 4  颈动脉体瘤(箭头所示)

  • [1]

    王劲松, 李勇辉, 姚陈, 等. 颈动脉体瘤切除术后神经并发症的高危因素分析[J]. 中华普通外科杂志, 2020, 35(3): 191-194. doi: 10.3760/cma.j.cn113855-20191223-00762

    [2]

    Yu Q, Wang P, Shi H, Luo J. Carotid artery and jugular vein invasion of oral-maxillofacial and neck malignant tumors: diagnostic value of computed tomography[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 96(3): 368-372. doi: 10.1016/S1079-2104(03)00366-4

    [3]

    Lodder WL, Lange CA, Teertstra HJ, et al. Value of MR and CT Imaging for Assessment of Internal Carotid Artery Encasement in Head and Neck Squamous Cell Carcinoma[J]. Int J Surg Oncol, 2013, 2013: 968758.

    [4]

    Chitose SI, Ono T, Shin B, et al. Use of dynamic MRI during swallowing to assess carotid artery invasion by neck metastasis[J]. Head Neck, 2018, 40(2): 330-337. doi: 10.1002/hed.24960

    [5]

    Sivakumaran R, Mohamed AZ, Akhunbay-Fudge CY, et al. Internal Carotid Artery Test Balloon Occlusion Using Single Photon Emission Computed Tomography Scan in the Management of Complex Cerebral Aneurysms and Skull Base Tumors: A 20-Year Review[J]. World Neurosurg, 2020, 139: e32-e37. doi: 10.1016/j.wneu.2020.03.006

    [6]

    Zhengang X, Colbert S, Brennan PA, et al. Surgical management of metastases that involve the carotid artery in cases of primary squamous cell carcinoma of the head and neck[J]. Int J Oral Maxillofac Surg, 2013, 42(4): 440-445. doi: 10.1016/j.ijom.2012.11.015

    [7]

    Manzoor NF, Russell JO, Bricker A, et al. Impact of surgical resection on survival in patients with advanced head and neck cancer involving the carotid artery[J]. JAMA Otolaryngol Head Neck Surg, 2013, 139(11): 1219-1225. doi: 10.1001/jamaoto.2013.4917

    [8]

    Krol E, Brandt CT, Blakeslee-Carter J, et al. Vascular interventions in head and neck cancer patients as a marker of poor survival[J]. J Vasc Surg, 2019, 69(1): 181-189. doi: 10.1016/j.jvs.2018.04.058

    [9]

    Back LJJ, Aro K, Tapiovaara L, et al. Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta-analysis[J]. Head Neck, 2018, 40(6): 1305-1320. doi: 10.1002/hed.25093

    [10]

    Illuminati G, Schneider F, Minni A, et al. Resection of recurrent neck cancer with carotid artery replacement[J]. J Vasc Surg, 2016, 63(5): 1272-1278. doi: 10.1016/j.jvs.2015.10.098

    [11]

    喻国宁, 朱敏辉, 郑宏良, 等. 颈内动脉切除一期血管重建术治疗晚期颈部转移癌的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(10): 901-905. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2020.10.009

    [12]

    孙宇, 王晓雷, 张烨, 等. 大隐静脉重建颈动脉在头颈部恶性肿瘤手术治疗中的应用[J]. 中华解剖与临床杂志, 2020, 25(2): 129-134. doi: 10.3760/cma.j.cn101202-20191107-00336

    [13]

    孙滨, 邓先兆, 康杰, 等. 多学科联合诊治累及颈总动脉的晚期甲状腺恶性肿瘤[J]. 中华内分泌外科杂志, 2017, 11(4): 274-277. doi: 10.3760/cma.j.issn.1674-6090.2017.04.004

    [14]

    孙宇, 王晓雷. 头颈部肿瘤侵犯颈动脉治疗的研究进展[J]. 山东医药, 2020, 60(1): 105-108. doi: 10.3969/j.issn.1002-266X.2020.01.029

    [15]

    Suarez C, Fernández-Alvarez V, Hamoir M, et al. Carotid blowout syndrome: modern trends in management[J]. Cancer Manag Res, 2018, 10: 5617-5628. doi: 10.2147/CMAR.S180164

    [16]

    Chatani S, Sato Y, Murata S, et al. Transarterial Embolization for Bleeding in Patients with Head and Neck Cancer: Who Benefits?[J]. Laryngoscope, 2021, 131(11): E2777-E2783.

    [17]

    孙伟, 李肖. 头颈部肿瘤难治性出血的急诊介入栓塞治疗[J]. 中华肿瘤杂志, 2021, 43(2): 224-227.

    [18]

    Wilseck Z, Savastano L, Chaudhary N, et al. Delayed extrusion of embolic coils into the airway after embolization of an external carotid artery pseudoaneurysm[J]. J Neurointerv Surg, 2018, 10(7): e18.

  • 加载中

(4)

计量
  • 文章访问数:  1135
  • PDF下载数:  357
  • 施引文献:  0
出版历程
收稿日期:  2022-01-24
刊出日期:  2023-07-03

目录