Tsukahara Kiyoaki, Sugitani Iwao, Kawabata Kazuyoshi
Division of Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tatemachi, Hachiouji-Shi, Tokyo, Japan.
Acta Otolaryngol. 2009 May;129(5):575-9. doi: 10.1080/00016480802294401.
Sleeve resection of the trachea while preserving the paries membranaceus trachea appears useful for patients in whom papillary thyroid carcinoma has invaded as far as the tracheal mucosa.
While tracheal sleeve resection with end-to-end anastomosis is advantageous, risks of suture failure or other serious complications exist. Since feeding arteries enter the trachea from the posterior and lateral walls, we conduct tracheal anastomosis preserving the paries membranaceus trachea.
This study retrospectively examined therapeutic outcomes and postoperative complications for sleeve resection followed by end-to-end anastomosis in 12 patients between 1994 and 2005.
Tracheal suture failure occurred in one patient and sutures were redone. One patient developed esophageal fistula, but recovered with conservative treatment. One patient required re-intubation. In three patients, recurrent laryngeal nerves were paralyzed bilaterally. No patients displayed recurrence in the tracheal resection margin or preserved paries membranaceus trachea. The 10-year survival rate was 72.9%.
对于乳头状甲状腺癌已侵犯至气管黏膜的患者,保留气管膜部的气管袖状切除术似乎是有效的。
虽然气管端端吻合的气管袖状切除术具有优势,但存在缝合失败或其他严重并发症的风险。由于供血动脉从气管后壁和侧壁进入气管,我们进行保留气管膜部的气管吻合术。
本研究回顾性分析了1994年至2005年间12例患者行袖状切除并端端吻合术后的治疗效果和术后并发症。
1例患者出现气管缝合失败,重新进行了缝合。1例患者发生食管瘘,但经保守治疗后康复。1例患者需要再次插管。3例患者双侧喉返神经麻痹。气管切除边缘或保留的气管膜部均未出现复发患者。10年生存率为72.9%。