par Jortay, Albert
Référence Acta chirurgica Belgica (Ed. bilingue), 73, 4, page (385-411)
Publication Publié, 1974
Article révisé par les pairs
Résumé : 469 patients underwent 500 radical neck dissections: 311 simple unilateral neck dissections, 172 'commando' procedures and 17 bilateral one stage neck dissections, also monobloc. Operative mortality rate rises in proportion to the extent of the operation and especially to the age (5.5% under 60 yr and 13.0% after 60). Preoperative cervical radiotherapy increases the incidence and seriousness of cutaneous necrosis, the infections of the wound, the risks of mouth to neck fistula and of carotidal rupture. Various rules of technique for the prevention of skin necroses and fistulae are given together with the treatment of carotidal ruptures. Respiratory complications amount to 63% and cardiovascular to 22%. Resection of both internal jugular veins in bilateral neck dissection is invariably followed by cyanosis and edema of the face. Their pathogeny and venous substitution are described. Sequelae of the operation are described while stressing the importance of rehabilitation through kinesiotherapy.