lymph node dissection

Lymph node dissection is a method of removing the lymphoid tissue around the lesion and surrounding fat, muscle, nerves, blood vessels, etc., referred to as dissection. It has been the most widely used method for the treatment of metastatic cancer. Treatment of diseases: chronic lymphadenitis, retroperitoneal lymphadenitis Indication The primary tumor has been controlled or removed, no distant metastasis, no systemic contraindications, traditional cleaning should be performed when the following conditions occur around it. Contraindications The patient is too old and should be filled with poor general condition. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure 1. Incision: The outer edge of the mandibular angle of the affected side is curved along the anterior border of the sternocleidomastoid muscle to the upper sternal fossa. If a bilateral functional cervical lymph node resection is performed at the same time, the opposite side is made into the same arc-shaped incision, and the two arc-shaped incisions are connected to form a "" type. 2. Peeling the flap: Separate the flap from the platysma, forward to the midline of the neck, and back to the leading edge of the trapezius. 3. Ligation of the external jugular vein: the upper and lower ends of the sternocleidomastoid muscle are separated, and two gauze strips are passed through the upper and lower ends of the muscle to pull it back. Exposure and severing of the external jugular vein. 4. Clean the lymphatic tissues in the front of the neck: Separate the internal jugular vein and the vagus nerve from the top of the supraclavicular bone, cut off the scapula and remove the carotid sheath. Under the premise of retaining the internal carotid artery, vein and vagus nerve, the fat, lymphoid tissue, fascia and interstitial tissues of the anterior cervical region were cleaned from the bottom to the top; the submandibular gland, the second abdominal muscle and the hypoglossal nerve were preserved. 5. Clean the lymphoid tissues in the posterior area of the neck: Pull the sternocleidomastoid muscle to the front of the neck, and clean the fat, lymphoid tissue and fascia of each area after the neck from the supraclavicular fossa, and preserve the transverse carotid artery and accessory nerve. complication Such as lymphocytic leakage, wound infection, head and face edema, less serious complications include intracranial edema, blood vessel exposure or even rupture after wound infection, especially after high-dose radiotherapy in the neck. Long-term complications include neck scar deformity and paresthesia.