title: Treatments for complications of tracheal sleeve resection for papillary thyroid carcinoma with tracheal invasion.
abstract: OBJECTIVE
  To evaluate the treatment, prognosis, and complications of differentiated thyroid carcinoma with tracheal invasion. We report our outcomes from a single center using a tracheal sleeve resection.
  
  
  METHODS
  Retrospective analysis of clinicopathological data on tracheal sleeve resection in patients with thyroid cancer and accompanying tracheal invasion from January 2009 to July 2012. The postoperative complications were analyzed and the literature was reviewed.
  
  
  RESULTS
  Nineteen patients with thyroid carcinoma and accompanying tracheal invasion underwent tracheal sleeve resection followed by end-to-end anastomosis. The median survival time was 22 months. Five patients (5/19) developed postoperative complications. The major complications included bilateral recurrent laryngeal nerve paralysis (2 cases), tracheal anastomotic stenosis (1 case), esophageal fistula (2 cases), and anastomotic dehiscence (2 cases). The treatment for these complications included partial posterior cordectomy by CO₂ laser for bilateral recurrent laryngeal nerve paralysis; CO₂ laser treatment followed by postoperative external beam radiotherapy (EBRT) (20 Gy/10 times) for tracheal anastomotic stenosis, femoral anterior dissociative flap to repair esophageal fistula, and a T-tube positioned in the wound in cases of anastomotic dehiscence.
  
  
  CONCLUSIONS
  Tracheal sleeve resection remain a safe option with less morbidity and perioperative complications for the management of patients with differentiated thyroid carcinoma accompanied by intratracheal invasion.
authors.affiliation: Department of Vascular and Thyroid Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No. 107, Yanjiangxi Road, Guangzhou City, Guangdong Province 510120, PR China. Electronic address: linshj@sysucc.org.cn.
authors.forename: S
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Head and Neck Surgery, Guangzhou Medical University Cancer Institute and Hospital, No. 78, Hengzhigang Road, Guangzhou City, Guangdong Province 510095, PR China. Electronic address: lussi24@163.com.
authors.forename: H
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, No. 651, Dongfengdong Road, Guangzhou City, Guangdong Province 510060, PR China. Electronic address: liuxk@sysucc.org.cn.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, No. 651, Dongfengdong Road, Guangzhou City, Guangdong Province 510060, PR China. Electronic address: liql@sysucc.org.cn.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, No. 651, Dongfengdong Road, Guangzhou City, Guangdong Province 510060, PR China. Electronic address: yangak@sysucc.org.cn.
authors.forename: A
authors.initials: A
authors.lastname: Yang
authors.affiliation: Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, No. 651, Dongfengdong Road, Guangzhou City, Guangdong Province 510060, PR China. Electronic address: zhangquan@sysucc.org.cn.
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, No. 651, Dongfengdong Road, Guangzhou City, Guangdong Province 510060, PR China. Electronic address: guozhum163@126.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, No. 651, Dongfengdong Road, Guangzhou City, Guangdong Province 510060, PR China. Electronic address: chenyf@sysucc.org.cn.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D007825:Laryngectomy; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014132:Trachea / Q000601:surgery*; D014134:Tracheal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D014135:Tracheal Stenosis / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery; D014138:Tracheoesophageal Fistula / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000601:surgery
keywords: CO(2) laser; Complication; Sleeve resection; Thyroid carcinoma; Tracheal invasion