Adult ; Chylothorax ; etiology ; Female ; Humans ; Neck Dissection ; adverse effects

Humans ; Mouth Neoplasms ; surgery ; Neck Dissection ; adverse effects ; methods

Adult ; Aged ; Chylothorax ; etiology ; therapy ; Female ; Humans ; Middle Aged ; Neck Dissection ; adverse effects ; Retrospective Studies ; Thyroid Neoplasms ; surgery

Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P₂₅, P₇₅), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.
Male ; Female ; Humans ; Adult ; Middle Aged ; Thyroidectomy/adverse effects* ; Robotic Surgical Procedures/adverse effects* ; Retrospective Studies ; Blood Loss, Surgical ; Hypesthesia/surgery* ; Neck Dissection/adverse effects* ; Thyroid Neoplasms/surgery* ; Pain, Postoperative/surgery* ; Postoperative Complications/etiology*

OBJECTIVETo approach reasonable operational mode of differentiated thyroid cancer.

METHODSRetrospectively review 546 differentiated thyroid cancer patients who received bilateral thyroidectomy with or without cervical lymph node excision from January 2001 to December 2006.

RESULTSNo death case happened during operation and hospitalization. The positive percentage of cervical lymph node metastasis was 76.2% (358/470). The incidence rate of single lateral recurrent laryngeal nerve injury was 1.1% (6 cases), parathyroid gland partly injury was 0.4% (2 cases), superior laryngeal nerve injury was 0.7% (4 cases), bleeding was 0.6% (3 cases) and esophagus injury after operation was 0.2% (1 case). There were no bilateral recurrent laryngeal nerve injury found.

CONCLUSIONSTotal thyroidectomy is an essential operational mode for differentiated thyroid cancer. It is necessary to excise cervical lymph node when the tumor's diameter exceeds 1 cm.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neck Dissection ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; adverse effects ; methods

OBJECTIVEThe aim of this study was to examine the effects of deep branches of cervical plexus on trapezius muscle.

METHODSThe evoked electromyography of 32 trapezius of 16 SD rats was examined in different time and results obtained were processed by statistical methods.

RESULTSAfter cutting the accessory nerves, stimulating the deep branches of cervical plexus evoked the myoelectricity, the myoelectricity results varied according to different time.

CONCLUSIONThe deep branches of cervical plexus are another important motorial supply to trapezius muscles. After cutting the accessory nerves, if the branches were undamaged, the shoulder's function would be greatly preserved.

Accessory Nerve ; physiology ; Animals ; Cervical Plexus ; physiology ; Electromyography ; Male ; Muscle, Skeletal ; anatomy & histology ; innervation ; physiology ; Neck Dissection ; adverse effects ; Neck Muscles ; anatomy & histology ; injuries ; physiology ; Rats ; Rats, Sprague-Dawley ; Shoulder ; innervation

OBJECTIVE: Evaluating the function of the internal jugular vein after selective neck dissection on patients affected by squamous cell carcinoma of the head and neck by color Doppler ultrasonography. METHOD: Forty patients (76 internal jugular veins) who had undergone bilateral selective neck dissection(36 patients) or unilateral selective neck dissection (4 patients) were collected and divided into 2 groups depending on operation area. Group A consisted of 39 internal jugular veins (IJVs) which dissected level II, III and group B included 37 IJVs which disseted level II - IVor II - V spring the IJV. All patients underwent Doppler ultrasonography before and after selective neck dissection at the 1st and 3rd postoperative months. The following measurements were assessed in each test: presence of thrombosis, expiratory jugular flow, expiratory caliber, area both during expiratory and Valsalva maneuver, expiratory flow speed, Valsalva flow speed. All data were statistically analyzed in two groups by comparisons of preoperative conditions and postoperative conditions. RESULT: (1) None of the 76 internal jugular veins showed thrombosis before or after selective neck dissection. (2) Patency rate at the 1st and 3rd postoperative months were respectively 85.5% and 96.1%. Patency rate of the internal jugular vein in two groups showed no significant changes at the 1st and 3rd postoperative months (P > 0.05). (3) In group A, Valsalva flow speed showed no significant changes at the 1st postoperative months (P > 0.05), compared with preoperative; The remainings showed significant difference. Expiratory calibe, area during Valsalva maneuve, expiratory flow speed and Valsalva flow speed had significant difference at the 3rd postoperative months (P < 0.05), compared with preoperative. In group B, Valsalva flow speed showed no significant changes at the 1st postoperative months (P > 0.05), compared with preoperative; The remainings showed significant difference. Expiratory jugular flow had no significant difference at the 3rd postoperative months (P > 0.05), compared with preoperative; The remainings showed significant difference. All parameters at the 3rd postoperative months had significant difference compared with 1st postoperative months between these two groups, excepting expiratory flow speed. (4) Differences of the operation area had no significant impact on indications of the internal jugular vein (P > 0.05). CONCLUSION (1) None of the internal jugular veins showed thrombosis after selective neck dissection. The results indicate that thrombosis of the internal jugular veins can be avoided though careful operation, proper operative skill, appropriate management postoperation. (2) Although most of the parameters changed at early stage after selective neck dissection, many of them improved at the 3rd postoperative months, and expiratory jugular flow recovered to the normal range. The results indicate that the internal jugular veins can basically maintain its normal function at long time postoperation.
Carcinoma, Squamous Cell ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Jugular Veins ; diagnostic imaging ; physiology ; Neck Dissection ; adverse effects ; Postoperative Period ; Regional Blood Flow ; physiology ; Ultrasonography, Doppler ; Vascular Patency ; Venous Thrombosis ; prevention & control

OBJECTIVETo study the surgical management of fatal hemorrhage following head and neck surgery for cancer.

METHODSThe clinical data of 32 cases of fatal hemorrhage following head and neck surgery from 1976 to 2008 in our department were analyzed retrospectively.

RESULTSHemorrhage was caused by carotid blowout in 20 cases. The carotid ligation was performed in 13 cases, only 6 cases got long-term survival. In 12 cases, hemorrhage was caused by tracheo-innominate artery fistula, only 2 cases received surgical management, and no long-term survivors.

CONCLUSIONFatal hemorrhage following head and neck surgery is an uncommon but frequently fatal complication, and the successful management of it depends on early diagnosis and correct treatment.

Adult ; Aged ; Carotid Artery, Common ; surgery ; Female ; Head and Neck Neoplasms ; pathology ; radiotherapy ; surgery ; Humans ; Laryngectomy ; adverse effects ; methods ; Ligation ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Postoperative Hemorrhage ; etiology ; surgery ; Retrospective Studies ; Young Adult

Objective: To evaluate the complications of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach. Methods: A retrospective analysis of complications was conducted on 1, 198 cases of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach of the 960 th Hospital of the People's Liberation Army from February 2014 to March 2020. There were 263 men and 935 women, age ranged from 9 to 68 years old, and included 288 benign lesions and 910 malignancies according to preoperative imaging examination, FNAC, and intraoperative frozen pathology. Results: Surgical complications occurred in 187 (15.61%) patients, including 10 cases of temporary larynx nerve injury (0.83%), 1 case of permanent larynx nerve injury (0.08%), and 152 cases of temporary hypoparathyroidism (12.69%), no permanent hypoparathyroidism, 1 case of hypoglossal injury (0.08%), 2 cases of facial nerve jaw branch damage (0.17%), 2 cases of trachea injury (0.17%), no esophagus damage, 5 cases of celiac leakage (0.42%), 3 cases of neck skin adhesion (0.25%), 2 cases of subdermal bleeding (0.17%), 2 cases of skin burns (0.17%), 5 cases of hematoma (0.42%), 1 case of cephalic artery rupture (0.08%), 1 case of jugular vein rupture (0.08%), no tumor cultivation, no arm plex nerve, accessory nerve or phrenic nerve damage. Conclusion: Da Vinci robot thyroid surgery by bilateral axillo-breast approach is safe, with less severe complications.
Adolescent ; Adult ; Aged ; Axilla ; Breast Neoplasms ; Carcinoma, Papillary/surgery* ; Child ; Female ; Humans ; Male ; Middle Aged ; Neck Dissection ; Retrospective Studies ; Robotic Surgical Procedures ; Robotics ; Thyroid Neoplasms/surgery* ; Thyroidectomy/adverse effects* ; Young Adult

Objective:To investigate the risk factors of recurrence after surgical resection of differentiated thyroid carcinoma combined with iodine-131 and TSH（Thyroid stimulating hormone） inhibition therapy. Methods:From January 2015 to April 2020, the clinical data of patients with structural recurrence and without recurrence were retrospectively collected after surgical treatment combined with iodine-131 and TSH inhibition therapy in the First Medical Center of PLA General Hospital. The general conditions of the two groups of patients were analyzed and the measurement data in line with the normal distribution was used for comparison between groups. For measurement data with non-normal distribution, the rank sum test was used for inter-group comparison. The Chi-square test was used for comparison between the counting data groups. Univariate and multivariate regression analyses were used to determine the risk factors associated with relapse. Results:The median follow-up period was 43 months（range 18-81 months） and 100 patients（10.5%） relapsed among the 955 patients. Univariate analysis showed that tumor size, tumor multiple, the number of lymph node metastases>5 in the central region of the neck, and the number of lymph node metastases>5 in the lateral region were significantly correlated with post-treatment recurrence（P<0.001, P=0.018, P<0.001, P<0.001）. Multivariate analysis showed that tumor size（adjusted odds ratio OR: 1.496, 95%CI: 1.226-1.826, P<0.001）, tumor frequency（adjusted odds ratio OR: 1.927, 95%CI: 1.003-3.701, P=0.049）, the number of lymph node metastases in the central neck region>5（adjusted odds ratio OR: 2.630, 95%CI: 1.509-4.584, P=0.001） and the number of lymph node metastases in the lateral neck region>5（adjusted odds ratio OR: 3.074, 95%CI: 1.649-5.730, P=0.001） was associated with tumor recurrence. Conclusion:The study showed that tumor size, tumor multiple, the number of lymph node metastases in the central region of the neck>5 and the number of lymph node metastases in the side of the neck >5 are independent risk factors for recurrence of differentiated thyroid cancer after surgical resection combined with iodine-131 and TSH inhibition therapy.
Humans ; Thyroid Cancer, Papillary/surgery* ; Lymphatic Metastasis/pathology* ; Retrospective Studies ; Neck Dissection ; Thyroidectomy/adverse effects* ; Neoplasm Recurrence, Local/pathology* ; Thyroid Neoplasms/surgery* ; Risk Factors ; Adenocarcinoma ; Thyrotropin ; Lymph Nodes/pathology*