title: Segmental tracheal resection for invasive differentiated thyroid carcinoma. Our experience in eight cases.
abstract: OBJECTIVE
  In differentiated thyroid carcinoma (DTC), complete resection of local disease provides the longest survival and the best palliation. In pursuit of this goal, segmental tracheal or laryngotracheal resection can be performed on patients with DTC invading the airway. The study summarizes the technical aspects of the intervention and analyzes its results in eight patients.
  
  
  METHODS
  The results of eight tracheal or laryngotracheal resections for DTC invading the airway were analyzed. Three patients presented with local recurrent disease, whereas five underwent airway resection at the time of thyroidectomy or shortly after. All received a circumferential sleeve resection of the trachea (2–4 tracheal rings) that in three cases extended to the cricoid, followed by end-to-end anastomosis.
  
  
  RESULTS
  Pathologic evaluation identified seven papillary and one poorly differentiated carcinomas. No postoperative deaths occurred; one patient required surgical reexploration because of postoperative bleeding, and two air leaks resolved with conservative treatment. Functional results were excellent. During follow-up, one patient died of lung and bone metastases, while in two cases locally persistent/recurrent disease has been detected; two patients are currently free of disease, and in the last three cases only persistent thyroglobulin levels are indicative of residual disease.
  
  
  CONCLUSIONS
  In our experience, segmental airway resection is safe, provides excellent functional results, and can warrant adequate control of local disease.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mossetti
authors.forename: Nicola
authors.initials: N
authors.lastname: Palestini
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Bruna
authors.forename: Michele
authors.initials: M
authors.lastname: Camandona
authors.forename: Milena
authors.initials: M
authors.lastname: Freddi
authors.forename: Alberto
authors.initials: A
authors.lastname: Oliaro
authors.forename: Guido
authors.initials: G
authors.lastname: Gasparri
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome