Window resection of the trachea and secondary reconstruction for invasion by differentiated thyroid carcinoma

Ebihara, Mitsuru; Kishimoto, Seiji; Hayashi, Ryuichi; Miyazaki, Masakazu; Shinozaki, Takahiro; Daiko, Hiroyuki; Saikawa, Masahisa; Sakuraba, Minoru; Miyamoto, Shinpei

doi:10.1016/j.anl.2010.09.003

Cited by 40 publications

(40 citation statements)

References 12 publications

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“…(McCaffrey, ) However, reconstruction is challenging for large defects, especially those covering more than one‐half of the tracheal circumference. Several procedures have been reported for the reconstruction of large tracheal window defects, (Al‐Khudari, Sharma, Young, Stapp, & Ghanem, ; Ch'ng et al, ; Detwiller, Schindler, Schneider, & Lindau, ; Ebihara et al, ; Fujiwara, Maeda, Kuwae, Nakagawa, Nakao, ; Fukunaga et al, ; Fujiwara, Nishino, & Numajiri, ; Hamahata, Beppu, Yamaki, & Sakurai, ; Homma et al, ; Koshima, Umeda, Moriguchi, Handa, Akisada, & Orita, ; Kashiwa et al, ; Ninkovic, Buerger, Ehrl, & Dornseifer, ; Teng, Malkin, & Urken, ; Yu, Clayman, & Walsh, , ) including immediate(Al‐Khudari et al, ; Ch'ng et al, ; Fujiwara et al, ; Hamahata et al, ; Yu et al, , ) and secondary reconstructions (Detwiller et al, ; Ebihara et al, ; Fukunaga et al, ; Fujiwara et al, ; Homma et al, ; Koshima et al, ; Kashiwa et al, ; Ninkovic et al, ; Teng et al, ).…”

Section: Discussionmentioning

confidence: 99%

Immediate tracheal reconstruction with forearm flap and bone graft

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Immediate tracheal reconstruction with forearm flap and bone graft

et al. 2018

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“…Among case series of well-differentiated thyroid cancer, lung metastases were present in 13.8% (range, 6.5% to 20.0%) of patients at the time of or prior to diagnosis (7,(25)(26)(27)(28)(29)(30)(31) and esophageal involvement in 29.0% (range, 4.9% to 62.0%) (6,25,29,(31)(32)(33)(34)(35)(36). Lung metastases were also present at or prior to secondary tracheal tumor diagnosis in patients with renal cell carcinoma (22%), rectal cancer (85%), melanoma (16.7%), esophageal cancer (3%), colon cancer (33.3%), carcinoma with thymus-like differentiation (CASTLE; 12.5%) and breast cancer (40%) ( Table S1).…”

Section: Concurrent Metastasesmentioning

confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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Background: Secondary tracheal tumors arise from mural invasion by primary tumors in adjacent organs, metastatic lymph nodes or blood-born metastasis from distant sites. This systematic review aims to assess the presentation, management options, and clinical outcomes of these uncommon non-tracheal malignancies.Methods: Electronic searches of the MEDLINE database were performed to identify case series and individual case reports of tracheal invasion by primary non-tracheal tumors or metastatic disease. AllEnglish-language studies with available abstracts or articles containing primary data were included.Results: From 1978 to 2017, a total of 160 case reports or case series identified 2,242 patients with invasion of the trachea by tumors of adjacent organs (n=1,853) or by metastatic lymph nodes or hematogenous spread (n=389). Common primary sites of origin were thyroid, esophagus, and lung, and the most common presentation was metachronous (range of interval: 0 to 564 months) with dyspnea, neck mass, voice change and/or hemoptysis. A majority of patients in case reports (77.9%) and case series (66.0%) underwent resection and the most common reported operation was segmental tracheal resection. Fewer patients underwent bronchoscopic intervention (21.7%) and radiation was used in 32.2% of patients. Complications after bronchoscopic treatment included bleeding, granulation tissue, and retained secretions, while anastomotic leak, unplanned tracheostomy, and new recurrent laryngeal nerve paralysis were observed after surgical resection. The rate of 30-day mortality was low (0.01-1.80%). Median survival was higher in patients with thyroid malignancy and in patients who underwent surgical management. Follow-up time ranged from 0.03 to 183 months. Conclusions:Patients with tracheal invasion by metastatic or primary non-tracheal malignancies should be assessed for symptoms, tumor grade, tumor recurrence and concurrent metastases to decide on optimal surgical, bronchoscopic or noninterventional therapy. Clinical experience suggests that palliative endoscopic intervention for tracheal obstruction by metastasis-bearing lymph nodes is underreported.Keywords: Endotracheal metastasis; secondary tracheal tumors; systematic review Submitted Nov 24, 2017. Accepted for publication Dec 21, 2017Dec 21, . doi: 10.21037/acs.2018 View this article at: http://dx.doi.org/10.21037/acs.2018.02.01 Systematic Review IntroductionSecondary tracheal tumors are defined as tumors in, but not of the trachea and comprise a wide spectrum of tumor histologies and stages. There are no populationbased data for these tumors, and in clinical practice these lesions are probably more common than primary neoplasms. A thoracic surgeon probably encounters tracheal obstruction by metastatic lymph nodes more often than invasion by adjacent primary tumors. Since natural history and prognosis are related to the tumor of origin, their management and prognosis may differ considerably from primary tracheal neoplasms; a correct diagnosis with attribution to the origi...

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“…Usually, a two-stage surgical procedure is required: first, after resection of the tumor, the tracheal wall and skin are sutured, for the development of a persistent tracheocutaneous fistula "trough". Second, delayed closure of the tracheal defect with a stable framework is performed [11]. Therefore this technique involves long-term treatment and is also not always aesthetically satisfactory because of the need for harvesting a local flap.…”

Section: Discussionmentioning

confidence: 99%

“…We consider that our procedure was less invasive and therefore associated with less surgical stress than previously reported methods. When the resection range of the trachea is small (i.e., extending over 4 rings or less, and half of the circumference or less), closure can be performed without any problems using a local flap [11]. In the case of relatively large defects, however, this method cannot be applied due to the risk of collapse of the tracheal lumen.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Thyroid Carcinoma Invading the Trachea as a Single-Stage Procedure: A Case Report

Endo¹,

Ueno²,

Kondo³

et al. 2015

CRCM

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Objective: Locally advanced thyroid carcinoma is relatively rare; extrathyroid extension, such as to the trachea, is one of the most important prognostic factors. Surgical resection is the mainstay of treatment, and appropriate surgical planning is crucial for obtaining a reasonable prognosis and quality of life of the patients. Case Report: Herein, we report a case of advanced thyroid carcinoma involving the trachea. Total thyroidectomy and window resection of the trachea were performed. The tracheal defect was approximately 2.5 × 3.0 cm in size, extending from the first to the third tracheal cartilage, and was reconstructed with auricular cartilage and covered with the sternohyoid muscles of both sides in a single-stage surgical procedure. The tracheal stoma was closed 2 weeks after the surgery. There were no postoperative complications. Conclusion: This reconstruction of the relatively small defect of the trachea provided excellent functional and cosmetic results.

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Window resection of the trachea and secondary reconstruction for invasion by differentiated thyroid carcinoma

Cited by 40 publications

References 12 publications

Immediate tracheal reconstruction with forearm flap and bone graft

Immediate tracheal reconstruction with forearm flap and bone graft

Secondary tracheal tumors: a systematic review

Successful Treatment of Thyroid Carcinoma Invading the Trachea as a Single-Stage Procedure: A Case Report

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