CAJ | 학술논문

分化型甲状腺癌侵入气管内的外科治疗及气道重建
분화형갑상선암침입기관내적외과치료급기도중건
Surgical treatment and tracheal reconstruction of differentiated thyroid carcinoma with intraluminal tracheal invasion

万方数据

中华普通外科学文献（电子版） 중화보통외과학문헌（전자판）
CHINESE JOURNAL OF GENERAL SURGERY(ELECTRONIC VERSION)
2014年 1期 16-20 ,共5页

林少建%黄海燕%李秋梨%刘学奎%杨安奎%张诠%李浩%陈文宽%宋明%刘巍巍%陈艳峰%郭朱明

림소건%황해연%리추리%류학규%양안규%장전%리호%진문관%송명%류외외%진염봉%곽주명

甲状腺癌%术后并发症%气管%激光%袖状切除甲狀腺癌%術後併髮癥%氣管%激光%袖狀切除
갑상선암%술후병발증%기관%격광%수상절제
Thyroid carcinoma%Postoperative complication%Trachea%Laser%Sleeve resection

目的探讨分化型甲状腺癌侵入气管内的外科治疗方法及效果。方法回顾性分析分化型甲状腺癌侵入气管内的患者行气管袖状切除术后的治疗结果。16例分化型甲状腺癌（均为乳头状癌）侵入气管内的患者进行了颈部淋巴结清扫术+肿瘤整块切除术及气管袖状切除术，并一期行气管端端吻合术重建气道。结果16例患者手术均成功进行，术后并发症发生率为12.5%（2/16），其中气管吻合口狭窄1例，CO2激光加浅层放疗治愈；双侧声带麻痹1例，CO2激光切除一侧声带后分治愈。平均随访时间23个月，1例患者术后3个月出现局部淋巴结复发，再次术后带瘤生存；1例局部复发死亡。结论气管袖状切除-拉拢缝合术能有效治疗分化型甲状腺癌侵犯气管内，而CO2激光与浅层放疗对术后双侧声带麻痹及吻合口瘢痕增生是有效的。
목적탐토분화형갑상선암침입기관내적외과치료방법급효과。방법회고성분석분화형갑상선암침입기관내적환자행기관수상절제술후적치료결과。16례분화형갑상선암（균위유두상암）침입기관내적환자진행료경부림파결청소술+종류정괴절제술급기관수상절제술，병일기행기관단단문합술중건기도。결과16례환자수술균성공진행，술후병발증발생솔위12.5%（2/16），기중기관문합구협착1례，CO2격광가천층방료치유；쌍측성대마비1례，CO2격광절제일측성대후분치유。평균수방시간23개월，1례환자술후3개월출현국부림파결복발，재차술후대류생존；1례국부복발사망。결론기관수상절제-랍롱봉합술능유효치료분화형갑상선암침범기관내，이CO2격광여천층방료대술후쌍측성대마비급문합구반흔증생시유효적。
Objective To investigate the effect of tracheal sleeve resection in papillary thyroid cancer with tracheal invasion. Methods The outcome of tracheal sleeve resection in patients with thyroid cancer and tracheal invasion were retrospectively analyzed. Sixteen patients with papillary thyroid carcinoma and tracheal invasion underwent neck dissection, tumor en bloc resection, and tracheal sleeve resection followed by end-to-end anastomosis. Results The mobidity of postoperative complication was 12.5%. Tracheal anastomotic stenosis occurred in one patient, and was treated with laser CO2 and radiotherapy. Bilateral recurrent laryngeal nerve paralysis occurred in one patient postoperatively, and laser CO2 with bilateral posterior cordectomy was done. The median length of follow-up was 23 months. One patient displayed a regional lymph node recurrence and required further surgery 3 months after surgery, one patient died of local recurrence. Conclusion Tracheal sleeve resection is appropriate for the management of patients with papillary thyroid carcinoma and intraluminal tracheal invasion, and laser CO2 and/or radiotherapy are available to deal with bilateral recurrent laryngeal nerve paralysis and anastomotic restenosis.