Tracheal stent in surgery for tracheal stenosis caused by thyroid tumor

Abstract

Objective To discuss clinical application, value and effect of tracheal stent in surgical operation for tracheostenosis caused by thyroid tumor. Methods Clinical data of 6 patients with tracheal stenosis and dyspnea caused by thyroid tumor invasiveness or tracheal compression from Oct. 2015 to Sep. 2016 were retrospectively analyzed. Of the 6 patients, 1 case had nodular goiter and 5 cases had differentiated thyroid carcinoma (DTC) . Results All patients had dyspnea caused by thyroid tumor invasiveness or tracheal compression. Dyspnea relieved dramatically after tracheal stent was implantated under local anesthesia. Thyroidectomy was given later, with intraoperative tracheal intubation as well as anesthesia, and the surgery finally succeeded. One case with benign multinodular goiter received complete resection and 5 cases with DTC invading the trachea received complete resection of thyroid and neck lymph node dissection, followed by end-to-end anastomosis of invaded trachea sleeve resection. All patients got stage I healing in surgical wound. Five cases received radioactive 131I treatment as well as TSH suppression therapy after DTC surgery. All patients were alive and disease-free after a follow-up of 4 to 15 months. Conclusions For patients with tracheostenosis caused by thyroid tumor invasiveness or tracheal compression, operation under cardiopulmonary bypass is necessary if tracheal intubation is difficult. For hospitals without cardiopulmonary bypass, tracheal stent implantation can effectively relieve dyspnea symptom and reduce risk of tracheal intubation under anesthesia, which provides possibility for surgical treatment. Key words: Thyroid tumor; Tracheal stent placement; Dyspnea; Tracheostenosis