Paratracheal Dissection

Kazuyoshi Kawabata; Shin-etsu Kamata; Tomohiko Nigauri; Katsufumi Hoki; Hiroki Mitani

doi:10.5106/jjshns.6.161

N0リンパ節の処理

―傍気管部リンパ節郭清―

川端一嘉, 鎌田信悦, 苦瓜知彦, 保喜克文, 三谷浩樹

著者情報

キーワード: 気管傍郭清, 気管傍転移, 手術, 予防的郭清

ジャーナルフリー

1996 年 6 巻 3 号 p. 161-166

DOI https://doi.org/10.5106/jjshns.6.161

詳細

発行日: 1996/12/30 受付日: - J-STAGE公開日: 2010/07/27 受理日: - 早期公開日: - 改訂日: -
訂正情報
訂正日: 2010/07/27 訂正理由: - 訂正箇所: 論文抄録訂正内容: Wrong : Although there is general agreement that resection of paratracheal nodes is necessary to reduce the incidence of tracheal or stomal recurrence in subglottic carcinoma and hypopharyngeal carcinoma, there remains many things to be discussed. Our indications for paratracheal dissection are as follows now : 1. gllotic cance……all cases of total laryngectomy 2. subgllotic cancer …all cases 3. hypopharyngeal cancer and cervical esophageal cancer………all cases 4. tracheal cancer……all cases We change the extent of the dissection according to the size and location of the tumor. In cases of carcinoma of the hypophatynx, cervical esophagus and subgllotis, we undergo mediastinal paratracheal nodes dissection as deep as possible without manubrial resection. In this article we also present our surgical procedure.
Right : Although there is general agreement that resection of paratracheal nodes is necessary to reduce the incidence of tracheal or stomal recurrence in subglottic carcinoma and hypopharyngeal carcinoma, there remains many things to be discussed. Our indications for paratracheal dissection are as follows now : 1. gllotic cance……all cases of total laryngectomy 2. subgllotic cancer…all cases 3. hypopharyngeal cancer and cervical esophageal cancer……all cases 4. tracheal cancer……all cases We change the extent of the dissection according to the size and location of the tumor. In cases of carcinoma of the hypophatynx, cervical esophagus and subgllotis, we undergo mediastinal paratracheal nodes dissection as deep as possible without manubrial resection. In this article we also present our surgical procedure.

訂正日: 2010/07/27 訂正理由: - 訂正箇所: 引用文献情報訂正内容: Wrong : 1) Batsakis JG : Neoplasms of Larynx, In Batsakis JG. (ed), Tumors of the head and neck, 200-225. Baltimore, The Williams and Wilkins Company, 1979.
2) Kleinsasser O: Squamous cell carcinoma, In Kleinsasser O (ed), Tumors of the larynx and hypopharynx, 1-262. Tokyo, Nannkodo, 1988.
3) Gluckman L, Hamaker RC, Schller DE et al.: Surgical salvage for stomal recurrence, a multi institutional experience. Laryngo-scope 1987; 97 : 1025-1029.
4) Spiro RH : Less can mean more. Am J Surg 166: 322-325, 1993.
5) Sisson GA, Bytell DE, Becker SP : Media-stinal dissection 1976, indications and newer techniques. Laryngoscope 87 : 751-759, 1977.
6) Weber RS, Marvel J, Smith P, et al.: Paratracheal lymph node dissection for car-cinoma of the larynx, hypopharynx, and cervical esophagus. Otolaryngol Head Neck Surg 108 : 11-17, 1993.
7) Harrison DFN : The pathology and manage-ment of subgllotic cancer. Ann Otol Rhinol Laryngol 80:6-12, 1971.
8) Tong D, Moss WT, Stevens KR : Elective irradiation of the lower cervical region in patients at high risk for recurrent cancer at the tracheal stoma. Radiology 124 : 809-811, 1977.
9) Silver CE, Ferlito A : Total laryngectomy, In Silver CE, Ferlito A (eds): Surgery for cancer of the larynx and related structures Philadelphia, Saunders 159-181, 1996.

Right : 1) Batsakis JG : Neoplasms of Larynx, In Batsakis JG. (ed), Tumors of the head and neck, 200-225. Baltimore, The Williams and Wilkins Company, 1979.
2) Kleinsasser O: Squamous cell carcinoma, In Kleinsasser O (ed), Tumors of the larynx and hypopharynx, 1-262. Tokyo, Nannkodo, 1988.
3) Gluckman L, Hamaker RC, Schller DE et al.: Surgical salvage for stomal recurrence, a multi institutional experience. Laryngo-scope 1987; 97 : 1025-1029.
4) Spiro RH : Less can mean more. Am J Surg 166: 322-325, 1993.
5) Sisson GA, Bytell DE, Becker SP : Media-stinal dissection 1976, indications and newer techniques. Laryngoscope 87 : 751-759, 1977.
6) Weber RS, Marvel J, Smith P, et al.: Paratracheal lymph node dissection for car-cinoma of the larynx, hypopharynx, and cervical esophagus. Otolaryngol Head Neck Surg 108 : 11-17, 1993.
7) Harrison DFN : The pathology and manage-ment of subgllotic cancer. Ann Otol Rhinol Laryngol 80:6-12, 1971.
8) Tong D, Moss WT, Stevens KR : Elective irradiation of the lower cervical region in patients at high risk for recurrent cancer at the tracheal stoma. Radiology 124 : 809-811, 1977.
9) Silver CE, Ferlito A : Total laryngectomy, In Silver CE, Ferlito A (eds): Surgery for cancer of the larynx and related structures Philadelphia, Saunders 159-181, 1996.

抄録

　傍気管部リンパ節にたいする予防的郭清の必要性については,一般的なコンセンサスを得ていると考えられるが,その細部については曖昧である。我々の施設では,過去の症例における傍気管部リンパ節転移の状況より,声門上癌と初期声門癌を除く喉頭癌,下咽頭癌,頸部食道癌,気管癌など転移頻度の高いものを予防的郭清の適応としている。郭清範囲は原発巣の下方進展状態により少し異なり,下咽頭・頸部食道癌や声門下癌などでは上縦隔に向かってできるだけ深く郭清をおこなっている。ここでは,我々の施設での手術手技を中心に紹介する。

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