38542 Dissection, deep jugular node(s)

Name of the Procedure:

Dissection, deep jugular node(s)

• Common Names: Deep Jugular Lymph Node Dissection
• Medical Terms: Radical Neck Dissection, Cervical Lymphadenectomy

Summary

Dissection of deep jugular nodes is a surgical procedure where lymph nodes, tissues, and sometimes surrounding structures in the neck are removed to treat infections, cancer, or other conditions affecting these nodes.

Purpose

• Medical Condition: Treats cancer, infections, or other diseases affecting the deep jugular lymph nodes.
• Goals: Remove affected lymph nodes to prevent the spread of disease, relieve symptoms, and improve prognosis.

Indications

• Symptoms warranting the procedure: Swollen lymph nodes, palpable lumps in the neck, unexplained weight loss, night sweats, persistent hoarseness, or difficulty swallowing.
• Patient criteria: Diagnosed with head and neck cancer, metastatic cancer affecting lymph nodes, or persistent infections unresponsive to other treatments.

Preparation

• Pre-procedure instructions: Fasting (usually 8-12 hours before), medication adjustments, discontinuing blood-thinners if necessary.
• Diagnostic tests: Blood tests, imaging studies (CT, MRI, PET scans), biopsy of the lymph nodes.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A surgical incision is made along the neck.
3. Dissection: The surgeon carefully identifies and removes deep jugular lymph nodes and possibly affected tissues.
4. Closure: Incision is closed with sutures; a drain might be placed to remove excess fluids.
   • Tools/Equipment: Scalpels, forceps, retractors, surgical drains.

Duration

Typically takes 2-3 hours.

Setting

Performed in a hospital operating room or specialized surgical center.

Personnel

• Surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Common risks: Infection, bleeding, pain.
• Rare risks: Nerve damage leading to muscle weakness, numbness, or loss of function, difficulty swallowing, airway complications.
• Management: Antibiotics for infections, pain management strategies, addressing nerve complications through rehabilitation.

Benefits

• Expected benefits: Removal of diseased tissues, prevention of disease spread, symptom relief.
• Realization: Benefits usually noticed after initial recovery, often within a few weeks to months.

Recovery

• Post-procedure care: Pain management, wound care, keeping the surgical site clean and dry.
• Recovery time: Several weeks; avoiding strenuous activity, follow-up appointments for monitoring and removal of drains or sutures.

Alternatives

• Other treatments: Radiation therapy, chemotherapy, targeted drug therapy.
• Pros and cons: Less invasive alternatives may be tried initially but may not be as effective in advanced cases. Surgery offers a more definitive cure in many circumstances.

Patient Experience

• During the procedure: Unconscious under general anesthesia, no awareness of the surgery.
• After the procedure: Soreness, swelling, and discomfort in the neck area. Pain managed with medications, and comfort measures include rest and ice packs.