What is a radical neck dissection? when is it done?

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What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

Polyp of the Colon: Are polyps dangerous in the colon? Symptoms and causes

A polyp is a protruding growth which has a wartlike appearance. It can vary from a pinhead to a large orange in size. The word pertains to the shape of the growth and is used to describe any circumscribed bulge that protrudes into a body space. Polyps occur in many areas, but they are especially common in the nose and the intestinal tract. The colon is that part of the intestinal tract from which water is absorbed and in which the solid stool is formed, temporarily stored, and from which it is evacuated.

Polyps in the colon can cause bleeding and anemia as well as obstruction of bowel movement. They sometimes present a problem in diagnosis, for many polyps cause no symptoms at all. The presence of a polyp is established by an X-ray examination of the intestine or by looking directly into the intestine through a lighted tube (sigmoidoscope) inserted through the rectum.

Where do polyps of the colon come from? 

Polyps in this area are of two types. The one variety is a true tumor in the sense that it is a new growth. It is a benign disorder, since it is not a cancer. A polyp may not be innocent in the sense that it can, by bleeding or obstruction, produce very significant symptoms. Some cancers of the colon first present themselves in the shape of a polyp. They are not polyps; they are cancers which have a polyplike configuration. A second type of polyp of the colon results from an inflammation of its lining. The swelling becomes a lump that projects; hence it is a polyp. In strict terminology, projections of this kind are termed pseudopolyps or inflammatory polyps.

How many are there? 

Where a single one is encountered, a diagnostic search should be made for others. They are often multiple.

Why should the polyp be removed if it is not causing me any trouble? 

Some cancers look like polyps. We remove them to be sure they are not cancers of the polypoid type.

When can a polyp be left alone? 

Experience has indicated that if a polyp appears to be hanging by a long stalk, like a cherry on its stem, then it is unlikely to be cancerous. In such a case it is periodically observed and removed only if it causes symptoms.

If you already see the polyp in the rectum, why should I have an X ray? 

The X ray is required as a way of determining whether or not there are other polyps so that treatment can be planned. Another reason is that the polyp the surgeon sees may not be the cause of the bleeding, and it is necessary to be sure that there is nothing higher up, in the nature of another polyp, a tumor or a cancer.

Can a polyp turn into a cancer if left alone? 

Some polyps are cancer growths to start with. It's also known that polyps occur more frequently in patients who have a cancer of the intestine. It cannot be stated with absolute certainty whether a truly innocent polyp can change to cancer.

Can the polyp be removed without my having to stay in the hospital? 

Some polyps can be removed with the proper office equipment. Others are best removed on an ambulatory basis in the hospital or surgical clinic. If the polyp is large and there is the possibility of the presence of a large blood vessel, then it had best be managed during a hospital stay as an operating room procedure.

Will removal of the polyp stop my rectal bleeding and cure my cramps?

 If the polyp is truly the cause of the bleeding, its complete removal should stop all rectal bleeding. However, removal of the polyp does not ordinarily change the function of the colon as regards the frequency or the ease of bowel movements.

What do you actually do when you remove a polyp? 

The entire growth is completely removed, and the base from which it grows and receives its blood supply is destroyed.

Can this polyp recur or a new one appear? 

A polyp does not recur in the exact same place if it has been properly removed. New polyps may appear elsewhere or small ones may increase in size.

Why does this polyp have to be removed by an abdominal incision? 

It is too high up in the colon to be completely removed from below by instruments inserted into the rectum. Vve heard about a flexible instrument that makes it possible to take out high up polyps without having to be operated on.

Such an instrument is available. It is often inserted to get to growths high up in the colon. But sometimes the polyps are too large or so firmly attached that even this alternative method is either impractical or not completely safe. In selected cases this technique can be tried before resorting to a regular abdominal operation.

What is the abdominal operation? 

This is a procedure in which the abdomen is opened, just as for an appendectomy or for the removal of a gallbladder, and the polyp is removed from the colon. In some instances a portion of the colon is removed with the polyp. In these cases the two ends of the colon are joined again so that bowel movements will continue in the usual way.

What precautions do I have to take after the polyp is removed? 

You should appear for regular checkups. At that time, usually every six months, you will be sigmoidoscoped again to determine whether any new polyps have appeared. Obviously, if rectal bleeding recurs, come back promptly.

Should the rest of my family be examined for polyps? 

This visual inspection of the interior of the rectum (sigmoidoscopy) should be part of the annual general checkup of all patients over forty. Symptom free children should be examined for this only if they come from a family situation in which multiple hereditary polyps occur. This familial disease is an entity completely different from what we have been discussing.

What happens if I just don't do anything about the polyps? 

That would be an unwise attitude. You might just be lucky and get away with it and nothing will happen. On the other hand, it might bleed or it might be a cancer. It is better to treat it, especially when the risk of treatment is so small, rather than to worry or remain ignorant about what it is and what problems it can initiate.

How long will I be disabled by having this polyp removed?

 If the polyp can be removed as an office procedure you will lose no time at all. If removal of the polyp requires hospital equipment but is such that it can be done completely through the rectum, the hospitalization is ordinarily two or three days. If the treatment requires an abdominal operation, the hospital stay is for two or three weeks.

In the two first instances no time need be lost. In the last circumstance the convalescence period requires at least another two or three weeks. All indications about hospital time or duration of disability imply the usual care, with the patient free of collateral problems and no complications. Once having had a colonic polyp diagnosed or treated, the patient should be especially observant about blood in the stool.

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