title: [Surgery in the lateral area of the cervicothoracic border].
abstract: Surgery is not usually indicated for the involvement of cervical lymph node metastasis to the subclavian vein. Although surgery is indicated for the involvement of cervical lymph node metastasis to the venous angle, the usual visual field associated with cervical lymph node dissection cannot sufficiently visualize the subclavian vein, and the possibility exists of causing great vessel injury when involved lymph nodes are large and their mobility is restricted. In such cases, surgical excision may be avoided based on the expectation that ligating or cutting the internal jugular vein will be difficult. We examined 10 patients who underwent surgery for the adhesion or invasion of the primary tumor or involved lymph nodes to the venous angle or subclavian vein. The clavicle was removed or displaced to secure the visual field. The sternoclavicular joint was conserved and the clavicle, separated from the first rib, was lifted in 4 patients, while the medial two thirds of the clavicle was removed in 6 patients. Involved lymph nodes could be securely dissected without causing great vessel injury. A chylous leak occurred in one patient undergoing the procedure on the left side.
authors.affiliation: Department of Otorhinolaryngology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Mizuta
authors.forename: Bunya
authors.initials: B
authors.lastname: Kuze
authors.forename: Nansei
authors.initials: N
authors.lastname: Yamada
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Aoki
authors.forename: Yatsuji
authors.initials: Y
authors.lastname: Ito
mesh_terms: D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013350:Subclavian Vein / Q000601:surgery*; D016896:Treatment Outcome