After the second fatal laryngeal secondary report two cases of cervical bleeding.docVIP

 PAGE \* MERGEFORMAT 10 After the second fatal laryngeal secondary report two cases of cervical bleeding Authors: Jinshan Zhang Hongwei Xu Wei Lan Hung Fu Yin Keywords: Head and neck cancer Head and neck cancer after neck dissection neck, 20% ~ 40% of recurrence [1], if you choose appropriate patients underwent secondary surgery reduces pain, to save or prolong life. But because the re-operation, anatomical difficulties, surgical risks are great, and this time the majority of patients with poor general condition, serious complications can easily occur. Report of two cases of laryngeal cancer is the second postoperative bleeding in patients with secondary fatal and neck. A clinical data Cases of a male, 76 years old. For “total removal of larynx after 15 months showed bilateral neck mass 5 months” was June 14, 2006 was admitted to hospital have been OK radiotherapy, the dose 800cGy/4F (can not tolerate the termination); examination: the right carotid triangle palpable 3cm × 4cm size of the tumor, two submandibular reach the size of 2cm × 2cm mass, quality hardware, no tenderness, activities, poor. MRA Tip: no abnormal carotid artery, right internal jugular vein signal interrupted the middle of left cervical vein stenosis. Fully improve the preoperative preparations, rows under general anesthesia bilateral radical neck dissection left cervical vein reconstruction + + the left pectoralis major muscle flap transplantation, intraoperative ligation of bilateral external carotid artery, internal carotid vein, take the left great saphenous vein is about 12cm to-side anastomosis on the left internal jugular vein, intraoperative infiltration of tumor tissue to see the left common carotid artery adventitia, smooth dissection. After anti-infection, lowering blood pressure, phlegm, nutrition support, treatment, after 13d vital signs were stable, the general condition improved markedly. However, after 18d, suddenly vomited blood, within the micr