Bilateral resection and reconstruction of internal jugular vein for thyroid carcinoma

Abstract

Two patients with thyroid carcinoma infiltrating bilateral internal jugular veins were treated. In reconstruction of the internal jugular vein by implantation of an autogenous venous segment or Gore-Tex artificial vessel, the repaired area soon became obstructed. The repaired area with the Impra-Flex artificial vessel became obstructed again one month after the implantation. In the reconstruction by ipsilateral end-to-end anastomosis between the internal and external jugular veins, good circulation was apparent even 2 years after the operation. The internal-external jugular vein anastomosis is expected to increase the safety of single-stage bilateral excision of the internal jugular vein, as an adjunct to total thyroidectomy, in the surgical treatment of thyroid carcinoma.

Internal to external jugular vein bypass allowing for simultaneous bilateral radical neck dissection

“…Takeichi et al utilized autogenous graft material and synthetic vascular prosthesis to reconstruct the IJV. 13 The reconstructed IJV, however, thrombosed, with subsequent salvage by EJV to proximal IJV anastamosis. In addition, several authors have also reported on spiral saphenous vein grafting in IJV reconstruction.…”

“…Takeichi et al first described an external jugular vein (EJV)‐to‐IJV anastamosis following failed reconstruction utilizing autologous and synthetic graft material . In 2000, Katsuno et al further characterized several reconstructive options for IJV reconstruction, including an EJV‐to‐IJV bypass graft (type A reconstruction) .…”

“…To mitigate the potential effects of increased ICP, several intraoperative reconstructive techniques have been proposed to facilitate a single-staged approach. [13][14][15][16][17][18] Takeichi et al first described an external jugular vein (EJV)-to-IJV anastamosis following failed reconstruction utilizing autologous and synthetic graft material. 13 In 2000, Katsuno et al further characterized several reconstructive options for IJV reconstruction, including an EJV-to-IJV bypass graft (type A reconstruction).…”

“…[13][14][15][16][17][18] Takeichi et al first described an external jugular vein (EJV)-to-IJV anastamosis following failed reconstruction utilizing autologous and synthetic graft material. 13 In 2000, Katsuno et al further characterized several reconstructive options for IJV reconstruction, including an EJV-to-IJV bypass graft (type A reconstruction). 19 We presently propose the largest series to evaluate clinical outcomes following type A reconstruction of the IJV, utilizing a proximal IJV-to-EJV anastamosis as a primary bypass modality.…”

Bilateral radical neck dissection with unilateral internal jugular vein reconstruction

“…Since then, we have adopted the policy of reconstructing one of the jugular veins with venous replacement grafts when bilateral sacrifice of the IJV is contemplated. While IJV reconstruction after bilateral RND has been described previously, 26–29 until recently 30 none of the publications were in the otolaryngologic literature. We report our experience with nine cases of IJV reconstruction and analyze our results in the light of the relevant literature.…”