Abstract
The vascular reconstruction was given to three cases with neck metastasis fixed to carotid artery. Primary lesion in all of 3 cases was laryngeal cancer and surgically treated 11 to 20 months before clinically manifesting the cervical metastasis.
End to end anastomosis with interposition was performed in one case, and patchangioplasty in 2 cases. Autologous vein (V. saphenamagna) was used for the transplantation.
Any complications were not encountered after the surgery. Microscopic sections of the removed carotid artery indicated the extension of the tumor into the external layer.
Preoperatively, it was not easy to determine the indication of this surgical treatment, even though angiography and CT scanning were applied. Careful palpation was one of the most useful examination for this point. Headache was probable to be one of the important sign of the tumor infiltration into carotid artery, because it was immediately disappeared after the surgery.
All of 3 cases were died of dissemination of the cancer 5 to 25 months after the reconstruction. One of the reasons of the poor prognosis as described above might be that the fact of the invasion of the cervical metastasis into carotid artery itself might indicate the advanced stage. However, the reconstructive surgery was probably helpful to prolong the survival period.
