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自从1906年Crile首倡采用切除颈部淋巴组织及其周围的非重要结构来治疗头颈部癌以来,关于选择性颈廓清的指征、时机及其治疗头颈部癌的价值等问题,多年来一直争论不休。本文综述近年来有关选择性颈廓清术的国外文献,以期得到新的启发。临床上无颈淋巴结转移时,在切除原发癌的同时,切除一侧或双侧的颈淋巴结,称为选择性颈廓清术(elective neck dissection,缩写为END)或预防性颈廓清术。 60年代提出把病变超出真声带的喉癌作为END的指征,曾是许多学者一致赞同的观点。近10年来,随着免疫学的不断发展、放疗技术的改进以及重视原发癌切除术后的随访工作,持不同意见的学者逐渐增多。重新讨论END在治疗头颈部癌中的作用,是有价值的。
Since 1906 Crile initiated the removal of non-vital structures of the neck and around the lymphoid tissue to treat head and neck cancer, indications concerning the selective neck dissection, timing and value of the treatment of head and neck cancer and other issues over the years It has been debated. No clinical cervical lymph node metastasis, while the removal of the primary carcinoma removal of one or both of the cervical lymph nodes, known as selective neck dissection (elective neck dissection, abbreviated as END) or prophylactic neck dissection. The past 10 years, with the development of immunology, radiotherapy improved postoperative follow-up and attention to the work of primary cancer, dissenting scholars gradually increased. END revert role in the treatment of head and neck cancer, is valuable.