Main Articles

Tracheal resection for thyroid cancer

A M Shenoy^a1, R Burrah^a1 c1, V Rao^a1, P Chavan^a1, R Halkud^a1, V B Gowda^a2, N Ranganath^a2, T Shivakumar^a1 and V Prashanth^a1

^a1 Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India

^a2 Department of Anaesthesiology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India

Abstract

Introduction: Thyroid cancers infiltrating the upper aerodigestive tract are not uncommon. The management of these cases can be demanding, with a high level of surgical skill required to achieve adequate primary resection and reconstruction.

Materials and methods: This study was a single institution series of seven patients, managed over two years, who underwent tracheal resection for advanced thyroid cancer. All patients were older than 45 years (range, 45–65 years) and were predominantly male (six of seven). All patients presented to us with a swelling in the neck. Fine needle aspiration cytology detected thyroid cancer in all patients. None of the patients required a tracheostomy prior to surgery; however, they all had varying levels of airway compromise. One patient had lung metastasis at presentation. In all patients, the airway was successfully secured with fibre-optic assisted intubation prior to surgery. All patients underwent a total thyroidectomy with tracheal resection and anastomosis. Montgomery's suprahyoid release was utilised to achieve adequate laryngeal drop. None of the patients required a tracheostomy in the post-operative period. All patients received adjuvant therapy with either radioiodine ablation and/or radiotherapy.

Conclusion: Tracheal resection and primary reconstruction is a feasible surgical procedure for patients with thyroid cancer infiltrating the upper aerodigestive tract, with good clinical outcomes. However, the morbidity of the procedure mandates careful case selection, airway management and meticulous surgical technique.

(Accepted August 24 2011)

(Online publication April 12 2012)

Key words

• Thyroid Neoplasms;
• Carcinoma;
• Pathology;
• Trachea;
• Surgical Procedures;
• Operative

Correspondence:

^c1 Address for correspondence: Dr Rajaram Burrah, Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India 560029 Fax: +91 080 6560723 E-mail: rajaram_bv@yahoo.com

Footnotes

Dr R Burrah takes responsibility for the integrity of the content of the paper

Competing interests: None declared