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Ventral cervical versus bilateral lateral approach for extirpation of mandibular and medial retropharyngeal lymph nodes in dogs

Wainberg, S. H., Oblak, M. L., Giuffrida, M. A.
Veterinary surgery 2018 v.47 no.5 pp. 629-633
dogs, lymph nodes, surgery, veterinarians
OBJECTIVE: To compare ventral cervical and bilateral lateral incisions for extirpation of mandibular and medial retropharyngeal lymph nodes in dogs. STUDY DESIGN: Prospective randomized, crossover controlled cadaver trial. SAMPLE POPULATION: Eight veterinarians with advanced surgical training. METHODS: Study participants were randomized to perform both techniques on paired cadavers. Time to extirpation of the first and last lymph node, length of incisions, and complications were recorded for both techniques. Participants were asked to rate satisfaction with their ability to identify local anatomy and lymph nodes as well as overall preferred technique by using a 10‐point numerical rating scale. RESULTS: The total length of skin incised for the bilateral lateral approach exceeded that of the ventral cervical approach by 52.1 mm (mean, P < .001). The surgical time for removal of all 4 lymph nodes did not differ between the 2 approaches. The bilateral lateral approach was preferred by 62.5% (5/8) of participants for visualization of mandibular lymph nodes, and the ventral cervical approach was preferred by 87.5% (7/8) of participants for visualization of local anatomy. Overall, 62.5% (5/8) preferred the ventral cervical approach and 37.5% (3/8) preferred the bilateral lateral approach. CONCLUSION: The ventral cervical approach was preferred by participants for its perceived superior visualization of local anatomy and access to lymph nodes for removal. This approach also resulted in an overall shorter incision length. CLINICAL SIGNIFICANCE: A ventral cervical or bilateral lateral approach allows successful removal of the medial mandibular and retropharyngeal lymph nodes in dogs, and surgical approach may be selected according to individual preference.