The Diagnosis And Treatment Of Occupied Lesions At The Root Of The Neck

ObjectiveExplore the diagnosis of occupied lesions at the root of neck, choose a rational surgical plan, and reduce the occurrence of complications.Materials and MethodsA total of78patients in the Qilu Hospital of Shandong University form Jan2005to Jan2011with intact data of the tumors at the root of the neck were retrospectively analyzed. Clinical manifestations, surgical measures and prevention of operative complications were summarized.ResultsAccording to the pathologic diagnosis,39of the78cases were esophageal carcinoma,27cases were substernal thyroid,5cases were neurinoma,2cases were neurofibroma,1case was the lymphatic metastasis of the cancer of the esophagus,3cases were cyst of the lymph-vessel and2cases were tracheal tumors.Surgical measures:27cases of esophageal carcinoma were performed the resection of esophageal carcinoma and the anastomosis between hypopharynx and stomach by moving up the stomach,7cases of esophageal were performed the anastomosis between hypopharynx and colon by moving up the colon and5cases of esophageal carcinoma were performed pectoralis major or laryngotracheal valve repair.27of the78cases were substernal thyroid were performed "low collar " approach.2cases of tracheal tumors were performed tracheotomy and tumorectomy. The rest of the38cases were performed "hemi-clamshell" approach. One of lymphatic cyst was not resected completely because of the conjunction of the important tissues. Complications of the operation:18of78cases had the complication (23.08%).9cases had hydrothorax,4cases had hoarseness,2cases had anastomotic fistula,1case had chylous fistula,1case had bleeding of the cavity, the lymphatic metastasis of the cancer of the esophagus had bilateral effusion of thorax and lease of neurofibroma origin from brachial plexus had upper limb disorders.Result of histopathology:39cases were epidermoid carcinoma,16cases were nodular goiter,2cases was nodular goiter accompanied papillary microcarcinoma,2cases were papillary carcinoma,1case was goiter accompanied papillary carcinoma,6cases were thyroid adenoma,5cases were neurinoma,2cases were neurofibroma,1case was the lymphatic metastasis of the squamous-cell carcinoma of the esophagus and3cases were cyst of the lymph-vessel.Prognosis:Follow up for3years. Three-year survival rate of malignant tumor was54.55%. One of lymphatic cyst which was not removed completely did not relapsed too.Conclusions1. The type of the tumors at the root of the neck was variety, it was difficult to diagnose.2. The best treatment of the therapeutic regimen was operation.3. It’s difficult to perform the operation because of complicated anatomical structure and too many complications.