Carotid artery resection and reconstruction with expanded polytetrafluoroethylene for head and neck cancer.
OBJECTIVE
There are controversies on management of carotid artery invasion in advanced head and neck cancer. En bloc resection has been considered a curative modality. In this study, we evaluated the feasibility of using expanded polytetrafluoroethylene (ePTFE) in reconstructing the common carotid artery in patients with carotid artery invasion requiring resection.


METHODS
A retrospective study including 13 patients managed from 2002 to 2005. All patients underwent en bloc resection of the tumor and internal carotid artery then reconstructed with ePTFE.


RESULTS
All patients had en bloc resection of the tumor together with internal carotid artery and reconstruction with ePTFE. Some patients required wound coverage with myocutaneous flaps in eight patients and local flaps in five patients. Intraoperative shunting was used in all patients. Intraoperative heparin infusion and postoperative low dose aspirin were used to prevent thrombosis. One patient developed graft blowout and he was treated with ligation without hemiplegia. One patient had minor stroke. The follow-up period was 18.4 +/- 8.6 months. No patient suffered from neurological deficit or graft occlusion. Disease survival was 61.5% in 1 year and 38.5% in 2 years. Overall survival was 18.3 months.


CONCLUSIONS
En bloc resection and tumor together with carotid artery and ePTFE reconstruction is shown to be a feasible modality in treatment of advanced head and neck cancer with carotid artery invasion.
Miao
Beiping
B
Department of Otolaryngology, Head and Neck Surgery, Qilu Hospital, Shandong University, Jinan, PR China.
Lu
Yongtian
Y
Pan
Xinliang
X
Liu
Dayu
D
D000328:Adult; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D013524:Surgical Flaps
D011138:Polytetrafluoroethylene