Rotolo Nicola, Cattoni Maria, Imperatori Andrea
Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Gland Surg. 2017 Oct;6(5):574-578. doi: 10.21037/gs.2017.08.05.
Thyroidectomy associated to tracheal resection with end-to-end anastomosis is the treatment of choice of thyroid tumor invading the tracheal wall and is associated with a good prognosis. However, the postoperative morbidity is not irrelevant. The present review aims to discuss the complications occurring after this aggressive surgical procedure. The search was performed using PubMed through an overarching for the following terms: "complication of tracheal resection [AND] invasive thyroid cancer". Postoperative complications rate after tracheal sleeve resection with end-to-end anastomosis for thyroid cancer invading tracheal wall range from 15% to 39%. Postoperative mortality is about 1.2%. The most common postoperative complications are: anastomotic dehiscence, airway stenosis, infections and bleeding. Tumor local recurrence can be considered a late on set complication. To conclude, in locally invasive thyroid cancer, resection of the thyroid with the tracheal segment interested by the tumor provides a good prognosis despite the non-negligible postoperative morbidity rate. Patients' selection and accurate surgical technique performing a tracheal tension-free anastomosis are mandatory to reduce postoperative morbidity and mortality.
甲状腺切除术联合气管切除端端吻合术是侵犯气管壁的甲状腺肿瘤的首选治疗方法,且预后良好。然而,术后发病率也不容忽视。本综述旨在探讨这种激进外科手术后出现的并发症。通过在PubMed上搜索以下关键词进行检索:“气管切除并发症 [AND] 侵袭性甲状腺癌”。甲状腺癌侵犯气管壁行气管袖状切除端端吻合术后的并发症发生率在15%至39%之间。术后死亡率约为1.2%。最常见的术后并发症有:吻合口裂开、气道狭窄、感染和出血。肿瘤局部复发可被视为晚期并发症。总之,在局部侵袭性甲状腺癌中,切除受肿瘤累及的甲状腺及气管段,尽管术后发病率不可忽视,但预后良好。必须进行患者选择并采用精确的手术技术进行无张力气管吻合,以降低术后发病率和死亡率。