title: Long-term results and functional outcome after cervical evisceration in patients with thyroid cancer.
abstract: BACKGROUND
  Surgical strategy in patients with thyroid cancer (TC) infiltrating the aerodigestive system is controversial. This study was undertaken to examine the long-term results of cervical evisceration (CE).
  
  
  METHODS
  Since 1995, 14 consecutive patients with advanced TC underwent total laryngectomy (LE, n = 6) or esophagolaryngectomy (ELR, n = 8). Patients with unusual thyroid neoplasms or metastases to the thyroid (n = 3) were excluded. For esophageal reconstruction, free jejunal grafts (n = 6) and gastric tubes (n = 2) were used.
  
  
  RESULTS
  Procedure-related morbidity and mortality were 42% and 14%, respectively. ELR was associated with a significant higher frequency of complications and reoperations compared with LE. Twelve-month and 30-month survival rates were 73% and 55%, respectively; 85% of the patients were satisfied with the surgical results. There were no long-term problems concerning food intake in the ELR patients. Two ELR patients were able to learn a substitutive voice.
  
  
  CONCLUSIONS
  Cervical evisceration in patients with TC is associated with significant perioperative morbidity and mortality requiring careful patient selection. Regarding long-term survival, local tumor control, and patient's satisfaction, however, CE should be taken into account in suitable patients with advanced TC.
authors.affiliation: Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany. michael.brauckhoff@medizin.uni-halle.de
authors.forename: Michael
authors.initials: M
authors.lastname: Brauckhoff
authors.forename: Anja
authors.initials: A
authors.lastname: Meinicke
authors.forename: Udo
authors.initials: U
authors.lastname: Bilkenroth
authors.forename: Kerstin
authors.initials: K
authors.lastname: Lorenz
authors.forename: Katrin
authors.initials: K
authors.lastname: Brauckhoff
authors.forename: Oliver
authors.initials: O
authors.lastname: Gimm
authors.forename: Phuong Nguyen
authors.initials: PN
authors.lastname: Thanh
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D007830:Larynx / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009361:Neoplasm Invasiveness; D011379:Prognosis; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome