Intraoperative Komplikationen bei Operationen im Halsbereich

Abstract

Intraoperative complications of neck surgery are uncommon and rarely life-threatening and exact anatomical knowledge and precise dissection are most important for prevention. Anatomical variants (e.g. non-recurrent nerve, extralaryngeal branching) predispose to damage of the recurrent laryngeal nerve. The use of intraoperative neuromonitoring (IONM) can prevent bilateral nerve damage but in cases of accidental nerve damage primary reconstruction can improve vocal cord function. Autotransplantation of parathyroid tissue can reduce the rate of hypoparathyroidism but cannot be postulated as a routine measure. Intraoperative bleeding can usually be well controlled and greater danger for the patient emanates from early postoperative bleeding for which many techniques (clip, ligature, vessel sealing) can be employed for prevention. Lesions of the thoracic duct can be controlled by clip, ligation or stitch. Smaller lesions of the trachea and esophagus can be secured with direct suture or muscle flap plasty. In cases of larger lesions plastic reconstruction or organ replacement can be necessary.

Value and Diagnostic Accuracy of Ultrasound‐Guided Full Core Needle Biopsy in the Diagnosis of Lymphadenopathy: A Retrospective Evaluation of 793 Cases

“…Another important factor favoring CNB/UFCNB is the consistently lower rate of postinterventional complications compared to SNE (0% to 8% versus 1% to 34% [11][12][13][14][15][16][17][18] ). In our UFCNB cohort, only 11 cases had complications (1.4%).…”

“…Nevertheless, minimally invasive techniques such as US‐guided core needle biopsy (CNB) are increasingly used as diagnostic procedures in unknown LA suspected of malignant lymphoma . The complication rates of CNB (0%–8%) are lower than those of surgical lymph node excision (SNE; 1%–34%) . In comparison to fine‐needle biopsies (needle diameter <1 mm), good results in sensitivity, specificity, and diagnostic accuracy (98.1%, 100%, and 98.7%, respectively) were achieved in small case series using CNB (needle diameter >1 mm) .…”

“…[8][9][10] The complication rates of CNB (0%-8%) [11][12][13][14] are lower than those of surgical lymph node excision (SNE; 1%-34%). [15][16][17][18] In comparison to fine-needle biopsies (needle diameter <1 mm), good results in sensitivity, specificity, and diagnostic accuracy (98.1%, 100%, and 98.7%, respectively) were achieved in small case series using CNB (needle diameter >1 mm). 19 In comparison to conventional CNB, the introduction of the new technology of ultrasound-guided full core needle biopsy (UFCNB) allows greater tissue gain in percutaneous biopsy 20,21 and may be an alternative diagnostic procedure to SNE.…”