抄録
In general, radical neck dissection has been performed for malignant tumor of the neck, for example, malignant struma, primary or metastatic tumor. So far, the performance of operation was very difficult when the infiltration of tumor has spread over the wall of main carotid artery. Ligation or resection of the carotid artery causes brain damage in high average. Recent development of vascular surgery has made such an operation feasible. This paper describes the technique of reconstructive surgery of carotid artery. One of the present authors (K. I.) devised the blood vessel suturing apparatus that has given the ideal anastomosis. This machine has been successfully used 419 times in 273 clinical cases of various vascular surgery. There has been no complication. This machine is especially useful for the reconstruction of the carotid artery because the time of blockade of the vessel can be very much saved, and the finding of the anastomosis is ideal, being no fear of postoperative thrombosis of the suture line.
In our clinic, the vascular reconstruction with radical neck dissection has been given to 23 cases of malignant tumor of neck and 5 cases of carotid body tumor have received vascular surgery with extirpation of tumor. The operative procedures of vascular surgery consisted of excision and insertion of graft, excision and simple anastomosis, patch graft with autovein, and direct suture of side wall of blood vessel. There were no operative death. Autovein graft was used for the insertion from common carotid artery to internal carotid artery, on the other hand, the synthetic graft was used only for the insertion at the common carotid artery. Detailed technique and secrets of reconstructive surgery in the radical neck dissection were described.
