Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2014
[Surgical treatment and reconstruction of thyroid carcinoma invading cervical esophagus and trachea full-thickness].
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Liu Hongwei, Li Zhendong, Dong Huilei, Leng Hui, Sun Haibo, Li Shuchun
Аннотация
OBJECTIVE: To summary the clinical therapy experience of thyroid carcinoma invading cervical esophagus and trachea full thickness and reconstruction of them to improve the survival rate and quality of life of these patients.
METHOD: In 33 patients with thyroid carcinoma inviding cervical esophagus and trachea, 7 patients were operated with total thyroid resection, 22 patients were operated with one lobectomy and the other side subtotal thyroid resection,and 4 patients were operated with partial lobectomy. Trachea local recection and intubation were performed on 19 patients, partial laryngectomy and pyriform sinus resection with trachea local recection and intubation were performed on 4 patients,and 10 cases were operated with tracheal sleeve resection and end to end anastomos.
RESULT: All patients were primary healing without tracheal anastomosis fistula, tracheal wall necrosis, esophageal fistula and pharyngeal fistula. One case had hypoparathyroidism after the operation and took a favorable turn a month later. Seven cases were dead (21. 21%). 1-year, 3-year, 5-year survival rates of the thyroid papillary carcinoma inviding cervical esophagus and trachea were 100.0%, 93.8% and 70.3%; 1-year, 3-year, 5-year survival rates of the thyroid carcinoma inviding cervical esophagus and trachea were 96.6%, 79.0% and 61.4%.
CONCLUSION: Thyroid carcinoma invading cervical esophagus and trachea full-thickness can be treated with surgical methods, and tracheal sleeve resection and end to end anastomos are the suitable methods.
METHOD: In 33 patients with thyroid carcinoma inviding cervical esophagus and trachea, 7 patients were operated with total thyroid resection, 22 patients were operated with one lobectomy and the other side subtotal thyroid resection,and 4 patients were operated with partial lobectomy. Trachea local recection and intubation were performed on 19 patients, partial laryngectomy and pyriform sinus resection with trachea local recection and intubation were performed on 4 patients,and 10 cases were operated with tracheal sleeve resection and end to end anastomos.
RESULT: All patients were primary healing without tracheal anastomosis fistula, tracheal wall necrosis, esophageal fistula and pharyngeal fistula. One case had hypoparathyroidism after the operation and took a favorable turn a month later. Seven cases were dead (21. 21%). 1-year, 3-year, 5-year survival rates of the thyroid papillary carcinoma inviding cervical esophagus and trachea were 100.0%, 93.8% and 70.3%; 1-year, 3-year, 5-year survival rates of the thyroid carcinoma inviding cervical esophagus and trachea were 96.6%, 79.0% and 61.4%.
CONCLUSION: Thyroid carcinoma invading cervical esophagus and trachea full-thickness can be treated with surgical methods, and tracheal sleeve resection and end to end anastomos are the suitable methods.