Gallegos-Hernández JF, Martínez-Gómez H, Flores-Díaz R

Language: Spanish
References: 27
Page: 369-376
PDF size: 71.39 Kb.

ABSTRACT

Radical neck dissection, described since the beginning of the past century, is currently the best surgical method to treat clinical or hidden nodal metastasis of carcinoma of upper respiratory and digestive tracts. It has three objectives: excision of metastatic nodes; adequate staging of patients without palpable nodes at time of diagnosis, and with the least possible morbidity. Different modifications to the original technique have been described with the purpose of achieving the same tumor control with the least possible morbidity; this has originated a wide variety of technique descriptions and the appearance of a vast nomenclature, originating confusion in relation to indications of each surgical variant. The objective of this article is to describe each variant of radical neck dissection and currently accepted indications based on literature. To synthesize, two pieces of knowledge arose during the twentieth century that changed the focus concerning neck dissection that they currently possessed: first, that a radical procedure does not necessarily imply the best oncologic treatment, and second, that extension of the procedure depends on neck characteristics at time of diagnosis. We know at present that even in patients with metastatic nodes, we can preserve non-lymphatic structures without impairing regional control and that in patients with palpable nodes we can select nodular groups with high risk for hidden metastasis and carry out selective procedures offering the least morbidity.

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