Reconstruction for Bilateral Internal Jugular Vein Perfusion Disruption
Ryunosuke Umeda1, Yoshiko Suyama1, Kohei Fukuoka1
1Department of Plastic and Reconstructive Surgery, Tottori University Hospital, Yonago 683-8503, Japan.
Yonago Acta Medica
|May 26, 2023
Summary
Bilateral internal jugular vein resection in head and neck cancer surgery requires staged dissection or reconstruction. End-to-side anastomosis of the internal jugular vein to the external jugular vein system offers a viable reconstruction option.
Area of Science:
- Vascular Surgery
- Head and Neck Oncology
Background:
- Bilateral internal jugular vein resection during head and neck cancer surgery necessitates staged neck dissection or venous reconstruction.
- Reconstruction methods like grafting or direct anastomosis to the external jugular vein have been described.
Observation:
- A patient undergoing supraglottic cancer resection experienced accidental injury to the left internal jugular vein after right internal jugular vein resection.
- The injury site near the subclavian vein precluded standard vein grafting.
Findings:
- Internal jugular venous return was successfully reestablished using an end-to-side anastomosis between the left internal jugular vein and the left external jugular vein system.
- Oblique incision of the internal jugular vein facilitated anastomosis without requiring precise caliber matching and maintained external jugular vein patency.
Implications:
- This end-to-side anastomosis technique provides a valuable alternative for internal jugular vein reconstruction in complex head and neck cancer cases.
- The method preserves external jugular vein blood flow, offering a potentially safer and more effective reconstruction strategy.
