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Tracheal resection for thyroid cancer

Published online by Cambridge University Press:  12 April 2012

A M Shenoy ,
R Burrah ,
V Rao ,
P Chavan ,
R Halkud ,
V B Gowda ,
N Ranganath ,
T Shivakumar  and
V Prashanth
A M Shenoy
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
R Burrah*
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
V Rao
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
P Chavan
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
R Halkud
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
V B Gowda
Affiliation:
Department of Anaesthesiology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
N Ranganath
Affiliation:
Department of Anaesthesiology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
T Shivakumar
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
V Prashanth
Affiliation:
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
*
Address for correspondence: Dr Rajaram Burrah, Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India560029 Fax: +91 080 6560723 E-mail: [email protected]
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Abstract

Introduction:

Thyroid cancers infiltrating the upper aerodigestive tract are not uncommon. The management of these cases can be demanding, with a high level of surgical skill required to achieve adequate primary resection and reconstruction.

Materials and methods:

This study was a single institution series of seven patients, managed over two years, who underwent tracheal resection for advanced thyroid cancer. All patients were older than 45 years (range, 45–65 years) and were predominantly male (six of seven). All patients presented to us with a swelling in the neck. Fine needle aspiration cytology detected thyroid cancer in all patients. None of the patients required a tracheostomy prior to surgery; however, they all had varying levels of airway compromise. One patient had lung metastasis at presentation. In all patients, the airway was successfully secured with fibre-optic assisted intubation prior to surgery. All patients underwent a total thyroidectomy with tracheal resection and anastomosis. Montgomery's suprahyoid release was utilised to achieve adequate laryngeal drop. None of the patients required a tracheostomy in the post-operative period. All patients received adjuvant therapy with either radioiodine ablation and/or radiotherapy.

Conclusion:

Tracheal resection and primary reconstruction is a feasible surgical procedure for patients with thyroid cancer infiltrating the upper aerodigestive tract, with good clinical outcomes. However, the morbidity of the procedure mandates careful case selection, airway management and meticulous surgical technique.

Keywords

Thyroid NeoplasmsCarcinomaPathologyTracheaSurgical ProceduresOperative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 6 , June 2012 , pp. 594 - 597
Copyright
Copyright © JLO (1984) Limited 2012

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