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

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.

What does a positive guaiac test indicate?

What is a sigmoidoscope?

This is an instrument which enables the doctor to view about 12 inches of the intestinal tract through the rectum. This is the area where polyps and cancers are most usually found. Small polyps can be removed with this instrument in the doctor's office with general or local anesthetics. The sigmoidoscope also allows a small portion of tissue to be extracted from the wall of the colon for laboratory testing. The procedure using the sigmoidoscope is called a sigmoidoscopy or proctosigmoidoscopy and should be included by your doctor as part of your annual physical exam if you are over 40 years of age, or earlier if you have a family history of colon cancer.

What causes tumors to form in the colon? 

The causes are unknown, but it is suspected that heredity as well as diet may play a role in some cancers of the colon. Conditions such as polyps, ulcerative colitis, and colitis also may be causes. Periodic checkups with a rectal examination make it possible for tumors to be discovered before they become dangerous.

What is involved when the doctor does a digital rectal examination? 

With a gloved finger, the doctor will probe the rectum for lesions. This examination will detect the presence of any masses in the lowest 4 inches of the rectum. The portion of stool on the gloved finger may be tested for blood.

How do I prepare for a proctosigmoidoscopy? 

Usually the doctor will instruct you to have a tap water enema the night before or the morning of the examination. The conventional instrument he uses is a sigmoidoscope, which allows him to view the last 12 inches of the colon.

Some doctors prefer a flexible fiberoptic sigmoidoscope, which allows viewing higher into the colon. If bleeding, obstruction, or diarrhea is present, the doctor will suggest a less vigorous bowel cleansing.

Is a proctosigmoidoscopy dangerous? 

No. Complications from this examination are rare but an inexperienced doctor could perforate the bowel, causing serious problems. This procedure is best done by a proctologist, a gastroenterologist or a physician who is trained to do this procedure.

What is the stool guaiac test? 

The guaiac (pronounced gwi yak) test (also called occult stool or stool blood test) is a simple, inexpensive method of testing stools for traces of blood. Usually stool samples are taken of three consecutive bowel movements so that if there is intermittent bleeding, this can be discovered. To increase the accuracy of the stool analysis, the doctor may ask you to start a meat free, high fiber diet 48 hours before the collection of the first stool specimen and continuing through the next 3 days. Vitamin C, iron and aspirin should be avoided during this time to ensure that the test is accurate.

Do hemorrhoids (piles) usually turn into cancer? 

No. However, hemorrhoids may exist along with cancer. Any rectal bleeding should be followed by an examination by the doctor to determine its cause. Do not assume that all bleeding is caused by hemorrhoids, because one of the symptoms of cancer of the colon or rectum is bright red blood in the stools.


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