Fiberoptic bronchoscopy in thyroid carcinoma with tracheal invasion

Area of Science:

• Oncology
• Thoracic Surgery
• Diagnostic Imaging

Background:

• Thyroid carcinoma can invade the trachea, complicating surgical management.
• Accurate preoperative assessment of tracheal invasion is crucial for successful tracheal sleeve resection.

Purpose of the Study:

• To compare preoperative bronchoscopic findings with histopathological results in thyroid carcinoma with tracheal invasion.
• To determine the accuracy of bronchoscopy in assessing the extent of tracheal wall invasion.

Main Methods:

• Retrospective analysis of 20 patients undergoing tracheal sleeve resection for thyroid carcinoma.
• Classification of bronchoscopic findings into five types based on tumor presence and tracheal compression.
• Comparison of bronchoscopic assessment with detailed histopathological examination of resected specimens.

Main Results:

• Bronchoscopic findings correlated with histopathological invasion extent.
• Adventitial invasion averaged 0.8 (max 2) tracheal rings beyond mucosal invasion.
• Bronchoscopy underestimated the number of involved tracheal rings in some cases.

Conclusions:

• Preoperative bronchoscopy may underestimate the extent of tracheal invasion in thyroid carcinoma.
• Resection of two additional tracheal rings beyond bronchoscopic indications is recommended for adequate margins.