Surgery Management of Advanced Stage Thyroid Carcinoma
Chenli Wuhao Huangqi
Department of Otolaryngology-Head and Neck Surgery, XinHua Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai 200092
[Abstract] Objective: To discuss diagnose, operation, and post-operation surgery management methods and treatment effect of the advanced stage thyroid carcinoma Methods: To summarize retrospectively diagnose and treatment information of the 22 patients. Among the total, four patients had congestive heart failure of four stage. The total patients primary thyroid lesions were resected and neck dissection were completed in operation, the level of thyroid carcinoma invading larynx, trachea, esophagus and hypopharynx was divided three types. TypeⅠ: The six cases invading the annulus tracheae perichondrium and the outer-wall of esophagus and hypopharynx, but not invading the cartilagines tracheales and hypopharyng-oesophagus muscular layer, were shaved off the invading part with electricity sword. TypeⅡ: To invading the cartilagines tracheales, trachea ring space tissue, or endomembrane lamina propria, the area is no more than 1.5cm2.The fenestration of trachea was used (1 case). The area of thyroid carcinoma invading hypopharyng or oesophagus mucosa was small, the defect parts were sutured directly (3 cases). TypeⅢ: If the full-thickness of larynx, hypopharynx, trachea and cervical esophagus were invaded, the invading parts of the organ were resected. These defects were repaired by end to end anastomosis of the trachea (8 cases), the folded pectoralis major myocutaneous flap (1 case), Sternocleidomastoideus flap with clavicular periosteum flap or clavicle skinnes flap (3 cases), band muscle and so on, and reconstructed the aerodigestive. If the larynx was`invaded and it ’s impossible to be preserved, the total larynx was resected. Results: The 22 patients were followed 1.5-5.0 years. Three died, the others are survival. Two ever appeared pharyngeal fistula after operation, the wound was healed by dressing change. Two patients came forth temporarily error swallow, Three cases who bilateral laryngeal recurrence nerve were resected in operation, two patients could speak with tracheal cannula, one patient can speak without tracheal cannula. The heart functions of three patients in these four congestive heart failure patients had obviously were improved after operation. Conclusions: Overall neoplasms were resected according to neoplasm surgery principle and preserve and reconstruct organ’s function to the best of our abilities to improve the patient survival rate and life quality.
Keywords: Thyroid Carcinoma Surgery treatment Staging作者: 锦心素颜 时间: 2014-12-10 21:32
赞一个！谢谢分享作者: 神小风 时间: 2014-12-11 09:46
学习作者: 程觉 时间: 2014-12-11 17:18
学习了，谢谢分享！作者: 赵杜霞 时间: 2014-12-11 22:16
谢谢分享，很棒！！！！作者: 杜金 时间: 2015-2-13 00:40
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