Gillenwater A M, Goepfert H
Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Semin Surg Oncol. 1999 Jan-Feb;16(1):19-29. doi: 10.1002/(sici)1098-2388(199901/02)16:1<19::aid-ssu5>3.0.co;2-w.
Well-differentiated thyroid cancer usually progresses slowly and rarely invades other tissues. However, the rare cases with invasion of local structures, such as the larynx, trachea, or esophagus, present particular management difficulties. In situations with limited involvement of the larynx or trachea, there is controversy over whether a "shave excision" that may leave microscopic disease at the site, or a complete resection that includes removal of a portion of these structures is the better approach. In the case of more extensive involvement of upper aerodigestive tract structures by thyroid carcinomas, the most appropriate method of resection and reconstruction is also at issue. We discuss the literature pertaining to the surgical management of laryngotracheal and esophageal invasion by thyroid carcinoma, review the incidence and presentation of this disease, and make recommendations based on our own experience.
高分化甲状腺癌通常进展缓慢，很少侵犯其他组织。然而，少数侵犯局部结构（如喉、气管或食管）的病例在治疗上存在特殊困难。在喉或气管受累有限的情况下，对于是采用可能会在局部留下微小病灶的“削除式切除术”，还是采用包括切除部分这些结构的完整切除术，存在争议。对于甲状腺癌更广泛侵犯上消化道结构的情况，最合适的切除和重建方法也存在争议。我们讨论了有关甲状腺癌侵犯喉气管和食管的外科治疗的文献，回顾了这种疾病的发病率和临床表现，并根据我们自己的经验提出建议。
