Symptoms and General Pathology

All Conditions

Neoplasms

Musculoskeletal Diseases

Mouth and Tooth Diseases

Diseases and Abnormalities at or Before Birth

Pain, Postoperative

Pain

Head and Neck Neoplasms

Micrognathism

Anti-Inflammatory Agents

Antineoplastic Agents

Antiemetics

Gastrointestinal Agents

All Drugs and Chemicals

Analgesics

Coagulants

Antirheumatic Agents

Adjuvants, Anesthesia

Central Nervous System Depressants

Dexamethasone

Dexamethasone acetate

BB 1101

Hemostatics

Diclofenac

Meperidine

The study group patients were treated using the LigaSure vessel sealing system (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) for dissection and hemostasis throughout the whole procedures during neck dissection.

Participants were asked to take a Voren enteric-microencapsulated (Diclofenac 50 mg/capsule) capsule 3 times a day for pain relief postoperatively. An additional capsule before sleep was allowed if persistent pain was told by the patient. When intolerable pain was complained in spite of oral analgesic, pethidine (meperidine 50 mg/ampule) injection was prescribed every 6 hours.

The control group patients were treated using conventional cold instrument dissection, monopolar electrocautery hemostasis, and suture ligation during neck dissection.

Participants were asked to take a Voren enteric-microencapsulated (Diclofenac 50 mg/capsule) capsule 3 times a day for pain relief postoperatively. An additional capsule before sleep was allowed if persistent pain was told by the patient. When intolerable pain was complained in spite of oral analgesic, pethidine (meperidine 50 mg/ampule) injection was prescribed every 6 hours.

The Small Jaw® handpiece (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) was not only used as a dissection forceps but also served as a ligation device.

Neck dissection

Shih-An Liu, MD, PhD

The aim of this prospective randomized study was to investigate if the LigaSure vessel sealing system can reduce the operation duration and the postoperative drainage amount in patients undergoing neck dissection.

We compared the differences in perioperative and postoperative variables between LigaSure Small Jaw®-assisted and conventional neck dissection in head and neck cancer patients.

Patients who were scheduled to undergo neck dissection due to head and neck cancer were eligible for this study. After receiving a detailed explanation, all patients signed an informed consent form before randomization. The study group were treated using the LigaSure vessel sealing system (Small Jaw®; Covidien, Colorado, USA) for dissection and hemostasis throughout the whole procedures during neck dissection. Relevant data included tumor-related variables, perioperative parameters, postoperative drainage status, postoperative subjective pain, and analgesic consumption amount were recorded and analyzed.

LigaSure Small Jaw® Versus Conventional Neck Dissection in Head and Neck Cancer Patients

A Prospective Randomized Study of LigaSure Small Jaw® Versus Conventional Neck Dissection in Head and Neck Cancer Patients

The duration from incision of cervial skin till the completion of lymph node dissection

Intraoperative blood loss was estimated by the sum of the volume in the suction bottle and the increased weight of wet gauzes containing blood after neck dissection.

The amount of drainage from closed system drainage tube

Visual analogue scale of subjective pain status after operation

The amount of analgesic consumption via oral ingestion after operation

The amount of injected form analgesic used (Meperidine 50 mg/ampule)

Taichung Veterans General Hospital

Attending physician

The study group patients were treated using the LigaSure vessel sealing system (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) for dissection and hemostasis throughout the whole procedures during neck dissection.

Ligasure small jaw (Covidien, Colorado, USA): The Small Jaw® handpiece (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) was not only used as a dissection forceps but also served as a ligation device.

Ligusure-assisted Neck Dissection

The control group patients were treated using conventional cold instrument dissection, monopolar electrocautery hemostasis, and suture ligation during neck dissection.

Conventional Neck Dissection

Total

Age, Categorical

Age, Continuous

Sex: Female, Male

Taiwan

Region of Enrollment

Oral cavity

Oropharynx

Thyroid gland

Others

Primary tumor site

Clinical N stage was in accordance with the guidelines of the American Joint Committee on Cancer (7th edition, 2009)

Briefly, the clinical N stage was described at below.

N0: No regional lymph node metastasis

N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension

N2: Metastasis of regional lymph node(s), none more than 6 cm in greatest dimension

Basically, a better survival is expected in N0 stage yet a worse survival is anticipated in N2 stage.

Clinical N stage

Level I, II, III

Level I, II, III, IV

Level II, III, IV

Level of cervical lymph node is based on the anatomical location

Briefly, the level of cervical lymph node is described as below

Level I: Submental and submandibular nodes

Level II: Upper jugular nodes - Between posterior belly of digastric muscles superiorly and hyoid bone inferiorly

Level III: Middle jugular nodes - between the hyoid bone and cricoid cartilage

Level IV: Lower jugular nodes - between the cricoid cartilage and the clavicle

Level V: Posterior cervical or spinal accessory nodes, posterior to the sternocleidomastoid muscle

Levels of neck dissection

Shih-An Liu

Opreation Duration

Intraoperative Blood Loss

Postoperative Drainage Amount

Baseline

6 hours after OP

12 hours after OP

1 day after OP

3 days after OP

7 days after OP

14 days after OP

The study group patients were treated using the LigaSure vessel sealing system (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) for dissection and hemostasis throughout the whole procedures during neck dissection.

Participants were asked to take a Voren enteric-microencapsulated (Diclofenac 50 mg/capsule) capsule 3 times a day for pain relief postoperatively. An additional capsule before sleep was allowed if persistent pain was told by the patient. When intolerable pain was complained in spite of oral analgesic, pethidine (meperidine 50 mg/ampule) injection was prescribed every 6 hours.

Neck dissection: The Small Jaw® handpiece (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) was not only used as a dissection forceps but also served as a ligation device.

Ligusure Assisted Neck Dissection

The control group patients were treated using conventional cold instrument dissection, monopolar electrocautery hemostasis, and suture ligation during neck dissection.

Participants were asked to take a Voren enteric-microencapsulated (Diclofenac 50 mg/capsule) capsule 3 times a day for pain relief postoperatively. An additional capsule before sleep was allowed if persistent pain was told by the patient. When intolerable pain was complained in spite of oral analgesic, pethidine (meperidine 50 mg/ampule) injection was prescribed every 6 hours.

Neck dissection: The Small Jaw® handpiece (Small Jaw® with ForceTriad®; Covidien, Colorado, USA) was not only used as a dissection forceps but also served as a ligation device.

Spots Global Cancer Trial Database for postoperative drainage