Liu Hongwei, Li Zhendong, Dong Huilei, Leng Hui, Sun Haibo, Li Shuchun
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Dec;28(24):1927-30.
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.
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.
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%.
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.
总结甲状腺癌侵犯颈段食管和气管全层并进行修复重建的临床治疗经验，以提高此类患者的生存率和生活质量。
33例甲状腺癌侵犯颈段食管和气管患者中，7例行甲状腺全切除术，22例行一侧甲状腺叶切除术加对侧甲状腺次全切除术，4例行甲状腺部分叶切除术。19例行气管局部切除及插管，4例行部分喉切除术加梨状窝切除术并气管局部切除及插管，10例行气管袖状切除术及端端吻合术。
所有患者均一期愈合，无气管吻合口瘘、气管壁坏死、食管瘘及咽瘘。1例术后出现甲状旁腺功能减退，1个月后好转。死亡7例（21.21%）。甲状腺乳头状癌侵犯颈段食管和气管患者的1年、3年、5年生存率分别为100.0%、93.8%、70.3%；甲状腺癌侵犯颈段食管和气管患者的1年、3年、5年生存率分别为96.6%、79.0%、61.4%。
甲状腺癌侵犯颈段食管和气管全层可采用手术方法治疗，气管袖状切除术及端端吻合术是合适的方法。
