Analysis of various defects and reconstructive methods after invasive thyroid carcinoma resection

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Invasive thyroid carcinomas can affect surrounding structures like the trachea, pharynx, and esophagus.
• Resection of these invasive tumors leads to complex defects requiring specialized reconstruction.
• Reconstructive strategies must be tailored to the specific defect size and affected organs.

Purpose of the Study:

• To analyze the patterns of defects resulting from invasive thyroid carcinoma resection.
• To document the reconstructive methods employed for these complex surgical defects.
• To provide a classification and understanding of post-resection defects and their management.

Main Methods:

• Retrospective review of 665 thyroidectomy patients from April 2011 to March 2021.
• Identified 25 patients (3.8%) with invasive thyroid carcinoma requiring reconstructive surgery.
• Analyzed defect types and corresponding reconstructive techniques, including tracheal anastomosis and pharynx closure.

Main Results:

• A classification system was applied to categorize defects (e.g., Tr0, Tr1a, Tr2b, Tr3a, PE1, S1, S2).
• Various reconstructive methods were used, including end-to-end tracheal anastomosis, pharyngeal closure, free flaps (forearm, jejunal), and musculocutaneous flaps (PMMC, DP).
• Specific flap choices and techniques were employed based on the extent of tracheal, pharyngeal, esophageal, or skin involvement.

Conclusions:

• The study defines complex defect patterns following invasive thyroid carcinoma resection.
• It describes the patterns of reconstructive methods used to address these defects.
• This analysis aids in understanding and planning surgical reconstruction for challenging thyroid cancer cases.