Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Thorac Cancer. 2022 Jun;13(12):1874-1877. doi: 10.1111/1759-7714.14470. Epub 2022 May 13.
Growing intrathoracic goiters may compress surrounding organs and deteriorate the cardiopulmonary function. Treating such cases requires carefully considering how to maintain oxygenation and resect the tumor with minimal invasiveness without complications. We herein report a surgically resected case of a large intrathoracic goiter-compressed trachea extending from the right lower pole of the thyroid gland to the carina. We secured the airway by intubation preparing for extracorporeal membrane oxygenation and successfully performed surgical complete resection using a robot-assisted thoracoscopic and cervical approach. Intrathoracic goiter is a tumor with abundant neovascularity, and the right vagus nerve is displaced in the thoracic cavity, but a robot-assisted thoracoscopic approach using CO insufflation improved visualization at the narrow apex area of the thoracic cavity. Robot-assisted thoracoscopic surgery is a useful surgical procedure enabling safe and minimally invasive surgery without recurrent laryngeal nerve palsy or tracheal injury for intrathoracic giant goiters extending into the thoracic cavity.
生长于胸腔内的甲状腺肿可能会压迫周围器官，使心肺功能恶化。治疗此类病例需要仔细考虑如何在保持氧合的同时，以最小的创伤性并避免并发症的情况下切除肿瘤。本文报告了一例手术切除的巨大胸腔内甲状腺肿压迫气管的病例，该甲状腺肿从甲状腺右下极延伸至隆突。我们通过插管为体外膜氧合做好气道准备，并成功地使用机器人辅助胸腔镜和颈部入路进行了手术完全切除。胸腔内甲状腺肿是一种富含新生血管的肿瘤，右迷走神经在胸腔内移位，但使用 CO2 充气的机器人辅助胸腔镜方法改善了胸腔狭窄顶点区域的可视化效果。机器人辅助胸腔镜手术是一种有用的手术方法，可安全、微创地进行手术，避免了胸腔内延伸的巨大甲状腺肿引起的喉返神经麻痹或气管损伤。
