甲状腺癌右侧颈淋巴结清扫术

取胸骨切迹上两横指切口,左侧至胸锁乳突肌前缘,右侧至胸锁乳突肌后缘,依次切开皮肤、皮下组织及颈阔肌,于颈阔肌深面游离皮瓣上至甲状软骨和颌下腺,下至锁骨和胸骨上凹。打开胸锁乳突肌外侧缘,打开颈动脉鞘,暴露右侧颈动脉、颈内静脉,清扫Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结。术中解剖显露二腹肌、舌下神经降支和静脉角,注意保护副神经、膈神经和颈丛。3-0丝线缝合颈阔肌,医用胶水关闭皮肤切口。

Right radical neck dissection

The incision was made two finger above sterna notch , between anterior edge of left sternocleidomastoid and postior edge of right sternocleidomastoid .Skin, subcutaneous tissues and platysma were dissected sharply .Superior flap up to thyroid cartilage and submandibular gland was mobilized , while inferior flap down to the clavicle and sternal notch was also mobilized .Lateral fascia of sternocleidomastoid was dissected and level V lymph nodes was carefully dissected with preservation of the external jugular vein . The carotid sheath was opened to expose the carotid and jugular vein .Level II,Ⅲ,Ⅳ and Ⅴ lymph nodes were en-bloc resected .The digastric was exposed and preserved as well as hypoglossal .Accessory nerve , phrenic nerve and cervical nerve were exposed and preserved .The platysma was closed with 3-0 silk suture and skin was closed with medical glue .