Krajl's operation: indications, description, possible complications. Lymph nodes in the neck

In the human body along the passage of lymphatic vessels are nodes that are real filters, where there is a filtration and neutralization of foreign substances. If there is an increase in lymph nodes, and this can be detected by probing or other types of research, then it can be argued that there is an inflammatory process. Therapy is timely leads to a normalization of their size, but there are situations where removal of the cervical lymph nodes is required. Consider in what cases this is required and what are the consequences.

The Krylya operation

This surgery is the main way to remove lymph nodes located on the neck. The technique was developed long ago, but is still used in surgery. The main task pursued by Krajl's operation is the disposal of lymph nodes afflicted with cancer cells.

The fact is that chemotherapy and irradiation are not able to eliminate metastases that affect the lymph nodes, so there is no way to do without surgical intervention. Lymph nodes under the jaw are removed if there is a malignancy of the language or this area. Sometimes you need to remove from both sides.

Arrangement of lymph nodes

It has already been said that an increase in lymph nodes indicates the presence of an inflammatory process in the body. Depending on where the lymph nodes on the neck are inflamed, you can make a conclusion about the beginning of the development of a particular pathology. Of course, only a specialist can do this.

An ordinary person should know that the lymphatic system plays a big role in protecting the body from foreign agents. Lymphonoduses are original filters that do not allow further penetration into the body of pathogenic bacteria and viruses. Lymph nodes under the jaw or elsewhere in the neck can destroy the degenerated cancer cells that pose a danger to humans.

Lymph nodes are located in many places of the body, but they can be divided into several groups:

1. Located on the front wall of the neck and back.
2. Ear.
3. Nuchal.
4. Chin and submandibular.

If the body is healthy, then it is difficult to probe the knots, because these are small formations. They are slightly mobile, but do not cause discomfort when pressing. Inflammation of the submaxillary lymph nodes may indicate a developing angina, and may become evidence of more serious pathologies. Only a specialist can determine this.

Causes of inflammation of the lymph nodes

Start to manifest themselves lymph nodes can under different circumstances, most often the reason for their increase is:

• Penetration of an infectious agent into the body.
• Chronic alcoholism.
• Injuries to the respiratory system or lesions in the oral cavity.
• Decreased immunity.
• Long stay in the cold.
• Lack of vitamins.
• Allergic reaction.
• Frequent stressful situations.
• Depression.
• Presence of AIDS or HIV.
• Development of the tumor process.

Thus, inflammation of the submaxillary lymph nodes can occur for many reasons, therefore it is the prerogative of a specialist to make a diagnosis.

Grounds for carrying out the operation

Physicians identify a number of indications for such an operative intervention:

• Severe lymph node involvement in the neck.
• Krajl's operation is also shown if several submandibular nodes have increased, cervical nodes are not affected, but there is a suspicion that they also suffer.
• After examining the bifurcation of the carotid arteries.

It should be noted that the decision to perform the operation is made only by the doctor, considering that such an operation is rather complicated in technique and has a strong impact on the patient's health.

That is why in some cases the doctor does not recommend it to be carried out, because the harm will be greater than the expected benefit.

Contraindications to the operation

In what cases are Krajl's surgery performed, we examined, but there are situations when it is better not to use such an operative intervention:

• If the metastases are in one place and do not spread anymore.
• If the patient's body is severely depleted, that is, cachexia occurs.
• A non-elderly age can be an obstacle to such an operation. Severe surgical intervention can provoke serious complications, which can be beyond the strength of the elderly organism.

Preparation of the patient for surgery

Naturally, the operation is performed under general anesthesia. For convenient work of the surgeon, the patient is placed on his back, a roll is placed under the neck.

The head rotates as far as possible in the direction opposite to the surgical intervention in order to create for the physician the best view of the place where the lymph nodes are on the neck. The hands must be fixed in a position at right angles to the body. After carrying out all the preparatory measures, the surgeon starts the operation.

Kra Операl operation: description

Operative intervention is carried out in stages. This is due to the fact that the removal of lymph nodes leads to disruption of the work of the jugular veins, so removal simultaneously from both sides will disrupt the cerebral circulation.

At the first stage, the lymph nodes are removed from the side where they are most damaged. A scalpel is used for the incision, which is changed with each subsequent dissection. Simultaneously with the dissection of the skin, it is necessary to carry out hemostasis. For its implementation, the nurse gives clamps to one of the assistants, while the second gently and carefully drains the operating field.

After the first stage of the operation, a break takes place for two to three weeks, and then the lymph nodes are removed from the other side.

Complications of the operation

Any operation is a rough and cardinal intervention in the functioning of the organism, therefore undesirable consequences are possible. Any surgeon must adjust himself to positive outcomes, but everything can be unpredictable. If the Krajl operation is performed, there are complications, and they can be divided into two groups:

1. Complications that appeared directly during the operation.
2. Delayed complications that appear already in the postoperative period.

In each group, complications of local and general nature can be identified.

The problems that arose during the operative intervention include:

• Damage to nerve trunks. This can subsequently lead to hoarseness of voice, the development of tachycardia, pneumonia.
• As a result of emphysema, pneumothorax may develop.
• If large vessels are damaged, then embolism arises with air.
• Abundant bleeding may even require a blood transfusion.
• Some other difficulties during the operation, which can not be predicted in advance.

It should be noted that all these complications the competent surgeon will overcome, timely carrying out the prophylaxis or changing the technique of the operation.

Effects of surgical intervention

The consequences after surgery are:

• Problems with breathing, which most often develop due to the laryngeal edema.
• Aspiration pneumonia. It can develop because of the accumulation of foreign substances in the lungs, for example, vomit.
• Bleeding, in this case, most often the doctor is to blame, who did not thoroughly sew the tissue.
• Swelling of the face.

• Cyanosis of the skin, especially in the mouth.
• Other consequences, in the appearance of which it is necessary to consult a doctor.

Post-surgery actions

Carry out an operative intervention - this is another half of the matter, it is important that the patient has a good postoperative period, and it is quite complicated, if the Krajl operation was carried out.

The patient from the operation room must be transferred to the intensive care unit, where he is followed by constant monitoring. During this period, it is very important to take all measures to prevent the development of postoperative complications.

To the patient, the doctor prescribes the following groups of drugs to accelerate the process of recovery of the body after such a rough intervention:

• Analgesics to reduce pain.
• Soothing drugs to relieve nervous excitement and anxiety.
• Be sure to take antibacterial drugs to prevent bacterial infection.
• Do not interfere with the injection of glucose to maintain the body.
• The body is faster to cope with the consequences of surgery, if you take fortifying drugs.

After the end of the operation and transfer to the intensive care unit, firstly anti-shock therapy is performed. The patient is placed in bed, which is preheated to room temperature, as a supplement can be used warmers, which are applied to the hands and feet.

After surgery to remove lymph nodes against the backdrop of oncology, it is mandatory to have X-ray therapy.

The medical staff should promptly process the wound after surgery with antiseptic solutions to prevent the development of the inflammatory process and the accumulation of pus. The dressing should be changed several times a day.

After the operation, it is also necessary to conduct the following activities:

• Do everything possible to prevent a disorder of cerebral circulation.
• Produce splinting.
• Take all measures to prevent the swelling of the larynx.
• If during the operation the patient lost a lot of blood, then a transfusion is needed.
• After surgery, the patient is assigned a special dietary diet.
• The doctor usually recommends that the patient engage in respiratory gymnastics, this should be given at least 5 minutes three times a day.

It should also be noted that the patient in the bed should be in a semi-sitting position. This improves the process of ventilation of the lungs. To improve breathing, additional oxygen is shown through the nose tube.

After the patient's condition is stabilized, he is transferred to a regular ward, where he is still under medical supervision for several days. Only when the patient's condition does not cause fears of doctors, he is discharged home, but the course of therapy can be continued, as a rule, the attending doctor gives important recommendations on observance of the work and rest regime, on nutrition, the dosage of physical activities that are excluded at first. It is possible that the doctor prescribes some medications that need to be taken.

Conclusion

It must be concluded in conclusion that the operation of Krajl's reviews is very different. This is understandable, the body of each individual and in his own way responds to cardinal interference in his work. So it turns out, there are patients who recover quickly after removal of the lymph nodes. But there is also a group that comes to life for a very long time. They need much more time to recover. Even after discharge, they are largely forced to limit themselves, strictly adhere to all the doctor's recommendations.

It must also be said that many patients who underwent the operation confirm that even after the end of inpatient treatment, it is necessary to take medications prescribed by a doctor, to comply with the regime, to eat right. Of course, this operation is a rude interference, but after it there is an opportunity to recover and lead a habitual way of life.