[Surgical treatment of well-differentiated thyroid carcinoma invading trachea: a report of 15 cases].
OBJECTIVE
At present head and neck surgeons from many countries have different opinions on management of well-differentiated thyroid cancer (WDTC). We will discuss WDTC invading trachea surgical treatment and its clinical significance.


METHODS
Retrospectively reviewed clinical data of 15 cases WDTC invading trachea, According to WDTC invading extent and grade, there were 3 kinds of surgical approaches: 1) end to end anastomosis; 2) tissue flap reconstruction; 3)larynx-tracheal dissociation.


RESULTS
15 cases underwent radical resection and reconstruct the defect of tracheal or larynx-tracheal dissociation. 2 cases received directly suture, 5 cases received sternocleidomastoid muscle flap reconstruction, 2 cases received pectorlis major muscle flap reconstruction, 2 cases received platysma flap reconstruction, 2 cases received free forearm flap with muticore titanium-board reconstruction, 2 cases received larynx-tracheal dissociation with larynx block out and tracheal fistula. 10 cases (10/15, 66.7%) received decannulation postoperation. Patients who were success fully decannulated could recover phonation and maintain airway breath. In the 5 patients who couldn't decannulate, underwent sternocleidomastoid muscle flap reconstruction, 1 underwent free forearm flap with muticore titanium-board reconstruction, 1 underwent pectorlis major muscle flap reconstruction, 2 underwent larynx-tracheal dissociation, but all of them could hardly utter voice by compress tracheostoma and needed permanent tracheostoma due to collapse of trachea. The recurrence rate of our group is 33.33%, 5 years survival rate is 88.89%.


CONCLUSIONS
WDTC with trachea invading easily cause dyspnea or emptysis influencing on 5 years survival rate. We should take more actively surgical approach to resect all the tumor and involved organ, thus improve survival rate and reduce recurrence postoperation.
Wu
Guo-Hao
GH
Department of Head and Neck, Cancer Center, Sun Yat-sen University, Guangzhou 510060, P.R.China. sumswuguohao@163.com
Li
Hao
H
Chen
Fu-Jin
FJ
Zeng
Zong-Yuan
ZY
Chen
Wen-Kuan
WK
Peng
Hang-Wei
HW
Zhang
Quan
Q
Yang
An-Kui
AK
Song
Ming
M
Tan
Guang-Mou
GM
Wei
Mao-Wen
MW
Yu
Wen-Bin
WB
D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013524:Surgical Flaps; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D014134:Tracheal Neoplasms / Q000473:pathology* / Q000601:surgery