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Carotid reconstruction in patients operated for malignant head and neck neoplasia
Nishinari, Kenji; Wolosker, Nelson; Yazbek, Guilherme; Malavolta, Luiz Caetano; Zerati, Antônio Eduardo; Kowalski, Luiz Paulo.
  • Nishinari, Kenji; Hospital do Câncer A.C. Camargo. Departamento de Cirurgia Vascular. Säo Paulo. BR
  • Wolosker, Nelson; Universidade de São Paulo. Faculdade de Medicina. Säo Paulo. BR
  • Yazbek, Guilherme; Hospital do Câncer A.C. Camargo. Departamento de Cirurgia Vascular. Säo Paulo. BR
  • Malavolta, Luiz Caetano; Hospital do Câncer A.C. Camargo. Departamento de Cirurgia Vascular. Säo Paulo. BR
  • Zerati, Antônio Eduardo; Hospital do Câncer A.C. Camargo. Departamento de Cirurgia Vascular. Säo Paulo. BR
  • Kowalski, Luiz Paulo; Universidade de Säo Paulo. Faculdade de Medicina. Säo Paulo. BR
São Paulo med. j ; 120(5): 137-140, July 2002. tab
Artículo en Inglés | LILACS | ID: lil-321231
RESUMO
CONTEXT Patients with malignant head and neck neoplasia may present simultaneous involvement of large vessels due to the growth of the tumoral mass. The therapeutic options are chemotherapy, radiotherapy, surgery or combined treatments.

OBJECTIVE:

To analyze the result of surgical treatment with carotid reconstruction in patients with advanced malignant head and neck neoplasia.

DESIGN:

Prospective.

SETTING:

Hospital do Câncer A.C. Camargo, Säo Paulo, Brazil.

PARTICIPANTS:

Eleven patients operated because of advanced malignant head and neck neoplasia that was involving the internal and/or common carotid artery. MAIN MEASUREMENTS By means of clinical examination, outpatient follow-up and duplex scanning, we analyzed the patency of the carotid grafts, vascular and non-vascular complications, disease recurrence and survival of the patients.

RESULTS:

Six patients (54.5 percent) did not present any type of complication. There was one vascular complication represented by an occlusion of the carotid graft with a cerebrovascular stroke in one hemisphere. Non-vascular complications occurred in five patients (45.5 percent). During the follow-up, eight patients died (72.7 percent), of whom seven had loco-regional tumor recurrence and one had pulmonary and hepatic metastases (at an average of 9 months after the operation). Seven of these patients presented functioning grafts. The three patients still alive have no tumor recurrence and their grafts are functioning (an average of 9 months has passed since the operation).

CONCLUSIONS:

Patients with advanced malignant head and neck neoplasia involving the carotid artery that are treated surgically present a prognosis with reservations. When the internal and/or common carotid artery is resected en-bloc with the tumor, arterial reconstruction must be performed. The long saphenous vein is a suitable vascular substitute
Asunto(s)
Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Arterias Carótidas / Neoplasias de Cabeza y Cuello Tipo de estudio: Estudio observacional Límite: Adulto / Humanos / Masculino Idioma: Inglés Revista: São Paulo med. j Asunto de la revista: Cirurgia Geral / Ciˆncia / Ginecologia / Medicina / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Año: 2002 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Hospital do Câncer A.C. Camargo/BR / Universidade de São Paulo/BR / Universidade de Säo Paulo/BR

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Arterias Carótidas / Neoplasias de Cabeza y Cuello Tipo de estudio: Estudio observacional Límite: Adulto / Humanos / Masculino Idioma: Inglés Revista: São Paulo med. j Asunto de la revista: Cirurgia Geral / Ciˆncia / Ginecologia / Medicina / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Año: 2002 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Hospital do Câncer A.C. Camargo/BR / Universidade de São Paulo/BR / Universidade de Säo Paulo/BR