Tracheal/Laryngeal Infiltration in Thyroid Cancer: a Single-Centre Experience.

Area of Science:

• Oncology
• Surgical Oncology
• Laryngology

Background:

• Locally advanced thyroid carcinoma frequently involves the trachea, affecting approximately one-third of patients.
• Tracheal infiltration presents challenges in surgical management, necessitating specialized resection techniques.
• Adequate resection remains the primary treatment modality despite tracheal involvement.

Purpose of the Study:

• To evaluate the outcomes of thyroidectomy combined with tracheal or laryngeal resection in locally advanced thyroid carcinoma.
• To analyze the surgical techniques, complications, and the importance of preoperative diagnosis in managing tracheal infiltration.

Main Methods:

• Retrospective analysis of 17 patients who underwent thyroidectomy with tracheal/laryngeal resection between January 2011 and December 2018.
• Surgical procedures included sleeve resection with end-to-end anastomosis, window resection, partial laryngectomy, and total laryngectomy.
• Preoperative assessment included bronchoscopy for bulky tumors and evaluation of symptoms like dyspnea and hoarseness.

Main Results:

• The mean age of patients was 57 years, with a female predominance (11 females, 6 males).
• Dyspnea (82%) was the most common presenting symptom, followed by hoarseness and hemoptysis.
• Two patients experienced postoperative complications: secondary hemorrhage after sleeve resection and salivary fistula after window resection with flap reconstruction. Both were managed with re-exploration and tracheostomy.

Conclusions:

• Thyroidectomy with tracheal or laryngeal resection is a viable treatment for locally advanced thyroid carcinoma with tracheal infiltration.
• Sleeve resection with end-to-end anastomosis was the most frequently employed technique.
• Preoperative diagnosis of tracheal infiltration is essential for meticulous surgical planning, patient counseling, and minimizing potential complications.