Treatments for complications of tracheal sleeve resection for papillary thyroid carcinoma with tracheal invasion
Treatments for complications of tracheal sleeve resection for papillary thyroid carcinoma with tracheal invasion
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DOI：
10.1016/j.ejso.2013.12.008
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发表时间：
2014-02-01
期刊：
影响因子：
3.8
通讯作者：
Chen, Y.
中科院分区：
文献类型：
--
作者：
Lin, S.;Huang, H.;Chen, Y.
目的：探讨分化型甲状腺癌侵犯气管的治疗方法、预后及并发症。我们报告我们的结果从一个单一的中心使用气管袖reference.Patients和方法：回顾性分析2009年1月至2012年7月的甲状腺癌患者气管袖切除术和伴随气管侵犯的临床病理数据。结果：19例甲状腺癌伴气管侵犯患者均行气管袖状切除后端端吻合术。中位生存期为22个月。5例患者（5/19）发生术后并发症。主要并发症包括双侧喉返神经麻痹2例，气管吻合口狭窄1例，食管瘘2例，吻合口裂开2例。这些并发症的治疗包括CO2激光部分后声带切除术治疗双侧喉返神经麻痹; CO2激光治疗后，术后外照射放疗（EBRT）。（20戈伊/10次）治疗气管吻合口狭窄，股前游离皮瓣修复食管瘘，吻合口裂开者伤口放置T管。气管袖状切除术仍然是一种安全的选择，发病率和围手术期并发症较少的分化型甲状腺癌伴气管内侵犯的患者的管理。(C)2014爱思唯尔有限公司版权所有。
Objective: To evaluate the treatment, prognosis, and complications of differentiated thyroid carcinoma with tracheal invasion. We report our outcomes from a single center using a tracheal sleeve resection.Patients and methods: Retrospective analysis of clinicopathological data on tracheal sleeve resection in patients with thyroid cancer and accompanying tracheal invasion from January 2009 to July 2012. The postoperative complications were analyzed and the literature was reviewed.Results: Nineteen patients with thyroid carcinoma and accompanying tracheal invasion underwent tracheal sleeve resection followed by end-to-end anastomosis. The median survival time was 22 months. Five patients (5/19) developed postoperative complications. The major complications included bilateral recurrent laryngeal nerve paralysis (2 cases), tracheal anastomotic stenosis (1 case), esophageal fistula (2 cases), and anastomotic dehiscence (2 cases). The treatment for these complications included partial posterior cordectomy by CO2 laser for bilateral recurrent laryngeal nerve paralysis; CO2 laser treatment followed by postoperative external beam radiotherapy (EBRT) (20 Gy/10 times) for tracheal anastomotic stenosis, femoral anterior dissociative flap to repair esophageal fistula, and a T-tube positioned in the wound in cases of anastomotic dehiscence.Conclusions: Tracheal sleeve resection remain a safe option with less morbidity and perioperative complications for the management of patients with differentiated thyroid carcinoma accompanied by intratracheal invasion. (C) 2014 Elsevier Ltd. All rights reserved.