J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 681KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 83(12): 1369-1376, 1982

Original article

RECONSTRUCTIVE SURGERY OF THE UPPER RESPIRATORY TRACT IN PATIENTS WITH THYROID CARCINOMA

1) First Department of Surgery, Osaka University Medical School
2) First Department of Surgery, Kagawa Medical School

Kazuyasu Nakao1), Masahiko Miyata1), Masaaki Izukura1), Yasuhiro Tanaka1), Tsuguo Sakamoto1), Kazuya Nakahara1), Yasumasa Monden1), Masazumi Maeda2), Yasunaru Kawashima1)

One of the serious factors threatening the life of patients with well differentiated carcinoma of the thyroid gland is an invasion of the neoplasma to the upper respiratory tract. We have surgically treated 13 patients with tracheal invasion of thyroid cancer. The lesion was confirmed preoperatively by tracheal endoscopy in 4 patients and the tracheal invasion was revealed by intraoperative biopsy in the other 6 patients. Difficulty of orotracheal intubation was encountered in 4 cases:Jet-injection was utilized in one, a tracheostomy to the surgically exposed trachea was done in one and an emergency use of extracorporeal circulation was prepared in 2 cases. Resection of the upper respiratory tract was carried out along with the subtotal or total thyroidectomy and neck dissection in all instances. Reconstruction of the trachea was performed by end-to-end anastomosis in 10 cases. Total laryngectomy and terminal tracheostomy were done in 3 cases. 11 cases are alive and well 4 to 48 months following the surgery. One patient died of tracheal bleeding from the recurrent carcinoma 21 months after the operation. Another patient died of postoperative gastrointestinal bleeding.

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