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病例报告:甲状腺癌侵犯气管:体外膜肺氧合辅助下的多学科切除与重建

Case report: Thyroid carcinoma invading trachea: Multidisciplinary resection and reconstruction assisted by extracorporeal membrane oxygenation.

作者信息

He Bo, Zhang Shixin, Ren Lin, Zhou Yi, Chen Qiao, Tang Jinghua, Zhang Yi, Tang Meng, Qiu Yang, Wang Haidong

机构信息

Department of Thoracic Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

出版信息

Front Oncol. 2023 Jan 12;12:990600. doi: 10.3389/fonc.2022.990600. eCollection 2022.

Abstract

BACKGROUND

When thyroid cancer invades the trachea, tumor resection and trachea reconstruction are required. Although the traditional way of anesthesia and tracheal intubation can maintain the necessary ventilation function during the operation, tracheal intubation affects the surgical field of vision and is not conducive to the protection of the recurrent laryngeal nerve beside the trachea during the operation.

CASE PRESENTATION

Extracorporeal membrane oxygenation (ECMO) is used to replace traditional tracheal intubation in the process of resection and end-to-end anastomosis of tracheal tumors, and complete tracheal tumor resection and trachea reconstruction are achieved.

CONCLUSION

Using ECMO for thyroid carcinoma resection, invaded trachea resection, and trachea reconstruction is safe and effective, which reduces the obstruction of endotracheal intubation on the operative field, guarantees the rapid and efficient end-to-end anastomosis in the upper trachea, and clearly avoids laryngeal recurrent nerve injury in the process of anastomosis.

摘要

背景

当甲状腺癌侵犯气管时,需要进行肿瘤切除及气管重建。虽然传统的麻醉和气管插管方式在手术过程中能够维持必要的通气功能,但气管插管会影响手术视野,不利于术中对气管旁喉返神经的保护。

病例介绍

在气管肿瘤切除及端端吻合过程中,采用体外膜肺氧合(ECMO)替代传统气管插管,实现了气管肿瘤的完整切除及气管重建。

结论

使用ECMO进行甲状腺癌切除、侵犯气管切除及气管重建安全有效,减少了气管插管对术野的遮挡,保证了上段气管快速高效的端端吻合,且能明显避免吻合过程中喉返神经损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/9878384/904e23f52b68/fonc-12-990600-g001.jpg

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