我院自1964年设计颈淋巴结清除术改进术式,特点是切口在斜方肌前缘和下颌骨下缘,顺颈筋膜解剖,由深至浅,自外而内,自上而下。先结禁颈内,外静脉上端及肿瘤区供应血管,进行肿瘤包围性切除,术野层次清楚,清除于净,损伤少,出血少。自1966—1980年间,应用此术式对1000例头颈癌瘤病人作了1006次颈淋巴结清除术。本文对此1000例病人的病种、病理类型,术前后淋巴结转移情况、临床分期、手术种类、麻醉、手术合并症和死亡率、疗效及生存率等作了临床分析。其5年和10年生存率分别为59.8％和53.4％,合并症为5.36％,死亡率仅为0.19％。实践证明,此术式具有省时,省血,安全,合并症少,疗效好,外形佳,技术较易掌握等优点。 Our hospital has designed a modified cervical lymph node dissection technique since 1964. It features an incision in the leading edge of the trapezius and the lower edge of the mandible. It is dissected along the cervical fascia, from deep to shallow, from the outside to the inside, and from the top down. The blood vessels were supplied to the neck and the upper end of the external vein and the tumor area. The tumor was surrounded by resection. The operative field was clear, and the net was clear. Less damage and less bleeding occurred. From 1966 to 1980, this procedure was used to perform 1006 cervical lymph node dissections on 1000 patients with head and neck cancer. This article made a clinical analysis of the disease types, pathological types, lymph node metastasis before and after surgery, clinical stage, type of surgery, anesthesia, surgical complications and mortality, efficacy and survival rate of this 1000 patients. The 5-year and 10-year survival rates were 59.8% and 53.4%, complications were 5.36%, and the mortality rate was only 0.19%. Practice has proved that this technique has the advantages of saving time, saving blood, safety, fewer complications, good curative effect, good shape, and easy mastery of technology.