Complications of neck dissection: Our initial experience
Article Sidebar
Main Article Content
Abstract
Abstract:
Introduction:
Neck dissection is an important surgical procedure to treat head-neck cancers. It also helps to stage the disease as well as denotes further treatment plan.
Materials and Methods:
A retrospective analytical study is done between August 2017-July 2021 in tertiary care hospital to identify methods and practices to reduce complications of neck dissection. 104 patients who met the selection criteria were reviewed. Any intraoperative as well as post-operative complication was carefully assessed and managed as per protocol.
Results:
62.5% were in the age group of 49-59 years. 66.35% were male. Maximum patient (65.38%) presented with oral cavity squamous call carcinoma. 51.92% had N1 neck node while 44.23% had N0 neck node. Internal jugular vein injury, spinal accessory nerve and marginal mandibular nerve injury, post-operative hematoma, seroma formation, chyle leak were found as significant complications in initial days. They were less in number or managed well with experience.
Conclusion:
Detailed knowledge of head-neck anatomy, meticulous dissection technique, early detection of any complication and its management can decrease the long-term morbidity and improve patient’s quality of life.
Keywords: Neck dissection, head-neck cancer, complication, meticulous haemostasis.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
References:
Crile G. Excision of cancer of head and neck. With special reference to the plan of dissection based on one hundred and thirty-two operations. Journal of the American Medical Association. 1906 Dec 1;47(22):1780-6. doi:10.1001/jama.1906.25210220006001a.
Martin H, Del Valle B, Ehrlich H, Cahan WG. Neck Dissection. Cancer. 1951 May;4(3):441-99. doi: 10.1002/1097-0142(195105)4:3<441::aid-cncr2820040303>3.0.co;2-o.
Bocca E, Pignataro O, Oldini C, Cappa C. Functional neck dissection: an evaluation and review of 843 cases. Laryngoscope. 1984 Jul;94(7):942-5. doi: 10.1288/00005537-198407000-00015.
Lefebvre JL, Andry G, Chevalier D, et al. Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma: 10-year results of EORTC trial 24891. Ann Oncol. 2012;23(10):2708-2714. doi:10.1093/annonc/mds065.
Masud MK, Ahmad SM, Karim MA, Ferdouse F, Fakir AY, Hanif MA, Abdullah M, Roy AS. Complications of neck dissection at a tertiary level hospital: study of 30 cases. Mymensingh Med J. 2014 Oct;23(4):658-66.
Malgonde MS, Kumar M. Complications after neck dissection. Med J DY Patil Univ 2015; 8:458-62. doi: 10.4103/0975-2870.160785.
Aslani M, Sultanem K, Voung T, Hier M, Niazi T, Shenouda G. Metastatic carcinoma to the cervical nodes from an unknown head and neck primary site: Is there a need for neck dissection? Head Neck. 2007 Jun;29(6):585-90. doi: 10.1002/hed.20581.
Sheetal A Murchite, Thakut Gowtham, Abhinandan Milind Kadiyal, Vinayak Gaikwad, Ashutosh Tiwari. Guidelines for safe and optimum neck dissection: a review article. Int Surg J. 2021 APR;8(4):1394-1401. doi: https://dx.doi.org/10.18203/2349-2902.isj20210979.
Edwards BM, Kileny PR. Intraoperative neurophysiologic monitoring: Indications and techniques for common procedures in otolaryngology-head and neck surgery. Otolaryngol Clin North Am 2005; 38:631-42, viii. doi: 10.1016/j.otc.2005.03.002.
Rödel R, Lang J. Peripheral branches of the facial nerve in the cheek and chin area. Anatomy and clinical consequences. HNO. 1996 Oct;44(10):572-6. doi: 10.1007/s001060050056.
Batstone MD, Lowe D, Shaw RJ, Brown JS, Vaughan ED, Rogers SN: Passive versus active drainage following neck dissection: a non-randomized prospective study. Eur Arch Otorhinolaryngol. 2009, 266 (1): 121-4. doi: 10.1007/s00405-008-0723-8.
Smoke A, Delegge MH: Chyle leaks: consensus on management?. Nutr Clin Pract. 2008 Oct-Nov;23(5):529-32. doi: 10.1177/0884533608323424.
Popovski V, Benedetti A, Popovic-Monevska D, Grcev A, Stamatoski A, Zhivadinovik J. Spinal accessory nerve preservation in modified neck dissection: surgical and functional outcomes. Acta Otorhinolaryngol Ital. 2017 Oct; 37(5): 368-374. doi: 10.14639/0392-100X-844.
Tatla T, Kanagalingam J, Majithia A, Clarke PM: Upper neck spinal accessory nerve identification during neck dissection. J Laryngol Otol. 2005 Nov, 119 (11): 906-8. doi: 10.1258/002221505774783511.
Suhas N. Bhusan, Arun H.N. Management of neck dissection complications in head and neck cancers. International Surgery Journal 2019 Feb;6(3):664. doi: 10.18203/2349-2902.isj20190811.