Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx
The study objective is to develop new approaches to improve the surgical treatment of laryngeal and hypopharyngeal cancer and the detection of cervical lymph node metastasis in the preoperative period by utilizing own clinical experience.Materials and methods. We conducted a retrospective analysis o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
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ABV-press
2019-07-01
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| Series: | Опухоли головы и шеи |
| Subjects: | |
| Online Access: | https://ogsh.abvpress.ru/jour/article/view/402 |
| _version_ | 1797876182940647424 |
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| author | E. I. Trofimov O. O. Sivkovich N. A. Daikhes V. V. Vinogradov S. S. Reshulckiy |
| author_facet | E. I. Trofimov O. O. Sivkovich N. A. Daikhes V. V. Vinogradov S. S. Reshulckiy |
| author_sort | E. I. Trofimov |
| collection | DOAJ |
| description | The study objective is to develop new approaches to improve the surgical treatment of laryngeal and hypopharyngeal cancer and the detection of cervical lymph node metastasis in the preoperative period by utilizing own clinical experience.Materials and methods. We conducted a retrospective analysis of 81 patients treated in Department of Otolaryngology in Scientific and Clinical Center of Otorhinolaryngology, Federal Medico-Biological Agency of the Russia. The 39 patients in the experimental group underwent total laryngectomy with neck dissection in our modification. With this proprietary technology modified vertical incision begins from occipital region, continues along the posterior border of the sternocleidomastoid muscle, crosses over this muscle and ends at sternoclavicular joint. The medial part of the sternocleidomastoid muscle was attached to the prevertebral fascia, thus swabbing the carotid neurovascular bundle. The patients in the control group underwent total laryngectomy and conventional neck dissection (42 patients). For morphological verification of cervical lymphadenopathies preoperative diagnostic included a fine-needle biopsy of suspected lymph nodes followed with cytology. The patients with negative cytology underwent harpoon percutaneous biopsy followed with cytological and histopathological examination of the lymph nodes.Results. Harpoon percutaneous biopsy increased accuracy of preoperative diagnosis from 59.3 to 96.3 % in our study, allowing the most favorable therapy; 3.7 % of lymph node metastases were not diagnosed before surgery. Because of this we believe, that preventive neck dissection is necessary.Conclusion. Harpoon percutaneous biopsy increased accuracy of histopathological diagnosis by 37 % as compared to fine-needle biopsy. We consider, that anchoring of the medial part of the sternocleidomastoid muscle to the prevertebral fascia allows the reliable separating of larynx and laryngopharynx from the carotid neurovascular bundle. |
| first_indexed | 2024-04-10T01:59:15Z |
| format | Article |
| id | doaj.art-efbe9972aa6d416ba825adc5cc435268 |
| institution | Directory Open Access Journal |
| issn | 2222-1468 2411-4634 |
| language | Russian |
| last_indexed | 2024-04-10T01:59:15Z |
| publishDate | 2019-07-01 |
| publisher | ABV-press |
| record_format | Article |
| series | Опухоли головы и шеи |
| spelling | doaj.art-efbe9972aa6d416ba825adc5cc4352682023-03-13T08:43:20ZrusABV-pressОпухоли головы и шеи2222-14682411-46342019-07-0192293410.17650/2222-1468-2019-9-2-29-34344Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynxE. I. Trofimov0O. O. Sivkovich1N. A. Daikhes2V. V. Vinogradov3S. S. Reshulckiy4ФГБУ«Научно-клинический центр оториноларингологии» ФМБА РоссииФГБУ«Научно-клинический центр оториноларингологии» ФМБА РоссииФГБУ«Научно-клинический центр оториноларингологии» ФМБА РоссииФГБУ«Научно-клинический центр оториноларингологии» ФМБА России; ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииФГБУ«Научно-клинический центр оториноларингологии» ФМБА РоссииThe study objective is to develop new approaches to improve the surgical treatment of laryngeal and hypopharyngeal cancer and the detection of cervical lymph node metastasis in the preoperative period by utilizing own clinical experience.Materials and methods. We conducted a retrospective analysis of 81 patients treated in Department of Otolaryngology in Scientific and Clinical Center of Otorhinolaryngology, Federal Medico-Biological Agency of the Russia. The 39 patients in the experimental group underwent total laryngectomy with neck dissection in our modification. With this proprietary technology modified vertical incision begins from occipital region, continues along the posterior border of the sternocleidomastoid muscle, crosses over this muscle and ends at sternoclavicular joint. The medial part of the sternocleidomastoid muscle was attached to the prevertebral fascia, thus swabbing the carotid neurovascular bundle. The patients in the control group underwent total laryngectomy and conventional neck dissection (42 patients). For morphological verification of cervical lymphadenopathies preoperative diagnostic included a fine-needle biopsy of suspected lymph nodes followed with cytology. The patients with negative cytology underwent harpoon percutaneous biopsy followed with cytological and histopathological examination of the lymph nodes.Results. Harpoon percutaneous biopsy increased accuracy of preoperative diagnosis from 59.3 to 96.3 % in our study, allowing the most favorable therapy; 3.7 % of lymph node metastases were not diagnosed before surgery. Because of this we believe, that preventive neck dissection is necessary.Conclusion. Harpoon percutaneous biopsy increased accuracy of histopathological diagnosis by 37 % as compared to fine-needle biopsy. We consider, that anchoring of the medial part of the sternocleidomastoid muscle to the prevertebral fascia allows the reliable separating of larynx and laryngopharynx from the carotid neurovascular bundle.https://ogsh.abvpress.ru/jour/article/view/402лимфатические узлырак гортани и гортаноглоткигарпунная чрескожная биопсияшейная лимфодиссекция |
| spellingShingle | E. I. Trofimov O. O. Sivkovich N. A. Daikhes V. V. Vinogradov S. S. Reshulckiy Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx Опухоли головы и шеи лимфатические узлы рак гортани и гортаноглотки гарпунная чрескожная биопсия шейная лимфодиссекция |
| title | Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx |
| title_full | Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx |
| title_fullStr | Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx |
| title_full_unstemmed | Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx |
| title_short | Optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx |
| title_sort | optimization of diagnostics and surgical treatment of metastatic cancer of the larynx and hypopharynx |
| topic | лимфатические узлы рак гортани и гортаноглотки гарпунная чрескожная биопсия шейная лимфодиссекция |
| url | https://ogsh.abvpress.ru/jour/article/view/402 |
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