Pulmonary thromboembolism following total laryngectomy and neck dissection: a case report

Yıl 2003, Cilt: 10 Sayı: 1, 36 - 38, 10.04.2003

Aslı Batur Çalış Hüseyin Seven Aras Şenvar

Öz

A fifty-five-year-old male patient undervvent total laryn­ gectomy, bilateral modified radical neck dissection, and primary voice restoration tor squamous celi carcinoma of the supraglottic larynx. During surgery the left internal jugular vein was found to be thrombosed and, therefore, ligated and resected. İn the early postoperative period, pulmonary thromboembolism was suspected and confirmed by lung perfusion scintigraphy which showed bilateral segmental and subsegmental perfusion defects. The patient was successfully treated by anticoagulant therapy. İt may be advisable to consider thromboprophylaxis in head and neck surgery in patients with elinically suspected pulmonary thromboembolism, if no contraindication exists.

Anahtar Kelimeler

Anticoagulants/therapeutic use, carcinoma, squamous cell/surgery, head and neck neoplasms/surgery, neck dissection, postoperative complications, pulmonary embolism/ etiology/drug therapy, risk factors, thrombosis/etiology

Total larenjektomi ve boyun diseksiyonu geçiren bir olguda pulmoner tromboemboli

Öz

Elli bafl yaflındaki erkek hastada supraglottik la- renkste skuamöz hücreli karsinom nedeniyle total la- renjektomi, iki taraflı modifiye radikal boyun diseksi- yonu ve primer ses restorasyonu uygulandı. Ameli- yat sırasında, sol internal juguler vende tromboz ge- lifltiğinin gözlenmesi üzerine ven kesildi ve bağlandı. Ameliyat sonrası erken dönemde hastada pulmoner tromboemboliden flüphelenildi. Akciğer perfüzyon sintigrafisinde iki taraflı segmental ve subsegmental perfüzyon defektleri izlendi. Uygulanan antikoagülan tedaviden baflarılı sonuç alındı. Bafl-boyun cerrahi- sinde pulmoner tromboemboliden flüphelenilen ol- gularda, herhangi bir kontraendikasyon yoksa trom- boprofilaksi uygulamasını dikkate almak gerekebilir

Anahtar Kelimeler

Antikoagulan/terapötik kullanım, karsinom, skuamöz hücreli/cerrahi, bafl-boyun neoplazmları/cerrahi, boyun diseksiyonu, ameliyat sonrası komplikasyon, pulmoneremboli/etyoloji/ilaç tedavisi, risk faktörleri, tromboz/etyoloji

Kaynakça

• Çelebi F, Balık AA, Yıldırgan MI, Bafloğlu M, Adıgüzel H, Ören D. Thromboembolic prophylaxis after major abdominal surgery. Ulus Travma Derg 2001;7: 44-8.
• Moreano EH, Hutchison JL, McCulloch TM, Graham SM, Funk GF, Hoffman HT. Incidence of deep venous thrombosis and pulmonary embolism in otolaryngolo- gy-head and neck surgery. Otolaryngol Head Neck Surg 1998;118:777-84.
• J o ffe SN. Postoperative deep vein thrombosis in oto- laryngologic surg e r y. Arch Otolaryngol 1976;102:135-6.
• Spires JR, Byers RM, Sanchez ED. Pulmonary throm- boembolism after head and neck surgery. South Med J 1989;82:1111-5.
• Lowry JC. Thromboembolic disease and thrombopro- phylaxis in oral and maxillofacial surgery: experience and practice. Br J Oral Maxillofac Surg 1995;33:101-6.
• Ah-See KW, Kerr J, Sim DW. Prophylaxis for venous t h romboembolism in head and neck surgery: the practice of otolaryngologists. J Laryngol Otol 1997;111: 8 4 5 - 9 .
• Toledano Munoz A, Monux Martinez A, Bernaldez Millan R, Galindo Campillo AN, Gavilan Bouzas J. T h romboembolic prophylaxis in patients with head and neck carcinomas: a risk-benefit study.Acta Otorrinolaringo l Esp 1999;50:453-7. [Abstract]