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Related Experiment Videos

Mediastinal dissection--1976: indications and newer techniques

G A Sisson, D E Bytell, S P Becker

    The Laryngoscope
    |May 1, 1977
    PubMed
    Summary

    This study revises surgical techniques for head and neck neoplasms invading the mediastinum. Transsternal radical neck dissections are refined to improve outcomes for patients with stomal recurrences after laryngectomy.

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    Head & neck·1993

    Area of Science:

    • Oncology
    • Surgical Oncology
    • Head and Neck Surgery

    Background:

    • Head and neck neoplasms can invade the mediastinum via direct extension or metastasis.
    • The clavicles and manubrium pose surgical challenges for complete resection of these neoplasms.
    • Previous work in 1962 reported mediastinal dissections for stomal recurrences post-laryngectomy.

    Purpose of the Study:

    • To present revised indications and surgical techniques for transsternal radical neck dissections.
    • To address complications associated with operating in previously treated (radiation/surgery) neck and mediastinal areas.
    • To improve management of head and neck neoplasms with mediastinal invasion and stomal recurrences.

    Main Methods:

    • Development and refinement of surgical techniques for manubrium and clavicle resection.
    • Preparation of regional flaps for oncologic resection in the neck and upper mediastinum.
    • Performance of over 60 transsternal radical neck dissections over 20 years.

    Main Results:

    • Evaluation of morbidity and survival rates in patients with stomal recurrences.
    • Demonstration of refined techniques to manage surgical barriers (clavicles, manubrium).
    • Application of these techniques in cases of direct extension or metastatic spread to the mediastinum.

    Conclusions:

    • Revised indications and techniques for transsternal radical neck dissection enhance surgical management.
    • Improved surgical approaches can overcome barriers posed by clavicles and manubrium in mediastinal invasion.
    • The study contributes to better outcomes for head and neck cancer patients with advanced disease and stomal recurrence.

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