顎顔面手術における一時的外頸動脈結紮術

Transient Ligation of the Carotid Artery in Maxillofacial Surgery

I．はじめに

　頭頸部とくに顎顔面の手術では手術野が狭く，出血により手術操作が制限されたり出血した場合止血操作が困難なことはしばしば経験される。大量出血の予想される全身麻酔下の悪性腫瘍症例に対しては，従来外頸動脈の結紮や低血圧麻酔など種々の方法が試みられてきた。今回われわれは主に頭頸部悪性腫瘍症例に対し一時的外頸動脈結紮術を施行しその効果を調べたので，その適応および限界について報告した。

　Transient ligation of the exernal carotid was performed during partial maxillectomy to minimize bleeding in 14 patients with maxillary cancer.

　The volume of bleeding ranged from 190ml to 2,500ml (798ml on average) and it had no relation with the method of anesthesia or surgical duration.

　Even though tumor received blood supply from the external carotid, this technique seemed insufficient when the maxillary artery was injured. However, in this case, the loss of blood during surgery was half compared with the surgery without ligating the external carotid.

　This is one of the useful technique to minimize bleeding if the cases were correctly selected. Advantages were discussed on the reestablishment of blood supply after surgery.