Surgical treatment and tracheal reconstruction of differentiated thyroid carcinoma with intraluminal tracheal invasion

doi:10.3877/cma.j.issn.1674-0793.2014.01.005

Abstract

Abstract:

Objective

To investigate the effect of tracheal sleeve resection in papillary thyroid cancer with tracheal invasion.

Methods

The outcome of tracheal sleeve resection in patients with thyroid cancer and tracheal invasion were retrospectively analyzed. Sixteen patients with papillary thyroid carcinoma and tracheal invasion underwent neck dissection, tumor en bloc resection, and tracheal sleeve resection followed by end-to-end anastomosis.

Results

The mobidity of postoperative complication was 12.5%. Tracheal anastomotic stenosis occurred in one patient, and was treated with laser CO₂ and radiotherapy. Bilateral recurrent laryngeal nerve paralysis occurred in one patient postoperatively, and laser CO₂ with bilateral posterior cordectomy was done. The median length of follow-up was 23 months. One patient displayed a regional lymph node recurrence and required further surgery 3 months after surgery, one patient died of local recurrence.

Conclusion

Tracheal sleeve resection is appropriate for the management of patients with papillary thyroid carcinoma and intraluminal tracheal invasion, and laser CO₂ and/or radiotherapy are available to deal with bilateral recurrent laryngeal nerve paralysis and anastomotic restenosis.

Key words: Thyroid carcinoma, Postoperative complication, Trachea, Laser, Sleeve resection

Shaojian Lin, Haiyan Huang, Qiuli Li, Xuekui Liu, Ankui Yang, Quan Zhang, Hao Li, Wenkuan Chen, Ming Song, Weiwei Liu, Yanfeng Chen, Zhuming Guo. Surgical treatment and tracheal reconstruction of differentiated thyroid carcinoma with intraluminal tracheal invasion[J]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(01): 16-20.

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Figures/Tables 6

References 14

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编号	性别	年龄(岁)	随访时间(月)	分化程度	切除气管环数	术后并发症	术后治疗	结局/原因
1	女	51	31	低	2	无	无	死亡/局部复发
2	女	61	33	高	2	双侧喉返神经麻痹	激光,同位素	正常
3	女	55	23	高	5	无	放疗	正常
4	女	49	15	高	6	无	无	正常
5	男	32	55	高	4	无	放疗	正常
6	男	68	30	高	4	无	同位素	正常
7	女	71	29	高	4	无	无	正常
8	男	56	29	高	3	无	无	正常
9	女	68	26	高	3	无	同位素	正常
10	男	69	19	高	4	无	同位素	正常
11	男	53	20	高	5	吻合口狭窄	激光,放疗	正常
12	女	48	11	低	5	无	无	带瘤生存/局部淋巴结复发
13	女	65	6	高	3	无	放疗	正常
14	男	62	9	低	4	无	放疗	正常
15	男	49	6	高	5	无	同位素	正常
16	女	35	2	高	2	无	同位素	正常

编号	性别	年龄(岁)	随访时间(月)	分化程度	切除气管环数	术后并发症	术后治疗	结局/原因
1	女	51	31	低	2	无	无	死亡/局部复发
2	女	61	33	高	2	双侧喉返神经麻痹	激光,同位素	正常
3	女	55	23	高	5	无	放疗	正常
4	女	49	15	高	6	无	无	正常
5	男	32	55	高	4	无	放疗	正常
6	男	68	30	高	4	无	同位素	正常
7	女	71	29	高	4	无	无	正常
8	男	56	29	高	3	无	无	正常
9	女	68	26	高	3	无	同位素	正常
10	男	69	19	高	4	无	同位素	正常
11	男	53	20	高	5	吻合口狭窄	激光,放疗	正常
12	女	48	11	低	5	无	无	带瘤生存/局部淋巴结复发
13	女	65	6	高	3	无	放疗	正常
14	男	62	9	低	4	无	放疗	正常
15	男	49	6	高	5	无	同位素	正常
16	女	35	2	高	2	无	同位素	正常

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