[Surgical management of papillary thyroid carcinoma with endotracheal infiltration].
OBJECTIVE
To investigate the diagnosis and treatment of papillary thyroid carcinoma with endotracheal infiltration.


METHODS
Clinical data of 12 patients treated from January 1999 to December 2006 were retrospectively analyzed. Six patients received tracheal partial resection-sternocleidomastoid musculoperiosteal flap reconstruction (group A). Six patients received tracheal sleeve resection-end to end anastomosis (group B).


RESULTS
Ten patients had the symptoms which indicated the tracheal invasion. Endotracheal focuses were detected in the region from 2 cm to 4 cm under glottis by endoscopy and positive rate of smear biopsy was 33%. Positive rate of CT scan was 92%. Mean diameter of carcinoma focus was 3.8 cm (from 3 cm to 7 cm), and mean number of tracheal ring resected was 4. For group A, even 7 rings were resected, and the longest longitude and latitude was 7 cm and 3 cm, respectively. For group B, the greatest number of rings resected was 4. Incidence rate of perioperative complication and mortality was 58% and 0%, respectively. Mean duration of follow-up was 49 months. One patient died of local recurrence, 1 patient died of lung metastasis. Two patients with tumor recurrence were also alive. For group A, extubation was successful in all patients.


CONCLUSIONS
Comprehensive use of diagnostic methods, especially MRI, will give detailed information for operation. Tracheal partial resection-sternocleidomastoid musculoperiosteal flap reconstruction and tracheal sleeve resection-end to end anastomosis are safe and useful methods to reconstruct the defects caused by tracheal operation.
Li
Duan-shu
DS
Department of Head & Neck Surgery, Cancer Hospital, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Wang
Yu-long
YL
Zhu
Yong-xue
YX
Shen
Qiang
Q
Huang
Cai-ping
CP
Ji
Qing-hai
QH
D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000473:pathology / Q000601:surgery*