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Long-term results and functional outcome after cervical evisceration in patients with thyroid cancer.

Brauckhoff, Michael (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
Meinicke, Anja (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
Bilkenroth, Udo (author)
Institute for Pathology, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany
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Lorenz, Kerstin (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
Brauckhoff, Katrin (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
Gimm, Oliver (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
Thanh, Phuong Nguyen (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
Dralle, Henning (author)
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany
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 (creator_code:org_t)
Elsevier BV, 2006
2006
English.
In: Surgery. - : Elsevier BV. - 0039-6060 .- 1532-7361. ; 140:6, s. 953-9
  • Journal article (peer-reviewed)
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  • BACKGROUND: Surgical strategy in patients with thyroid cancer (TC) infiltrating the aerodigestive system is controversial. This study was undertaken to examine the long-term results of cervical evisceration (CE).PATIENTS AND METHODS: Since 1995, 14 consecutive patients with advanced TC underwent total laryngectomy (LE, n = 6) or esophagolaryngectomy (ELR, n = 8). Patients with unusual thyroid neoplasms or metastases to the thyroid (n = 3) were excluded. For esophageal reconstruction, free jejunal grafts (n = 6) and gastric tubes (n = 2) were used.RESULTS: Procedure-related morbidity and mortality were 42% and 14%, respectively. ELR was associated with a significant higher frequency of complications and reoperations compared with LE. Twelve-month and 30-month survival rates were 73% and 55%, respectively; 85% of the patients were satisfied with the surgical results. There were no long-term problems concerning food intake in the ELR patients. Two ELR patients were able to learn a substitutive voice.CONCLUSIONS: Cervical evisceration in patients with TC is associated with significant perioperative morbidity and mortality requiring careful patient selection. Regarding long-term survival, local tumor control, and patient's satisfaction, however, CE should be taken into account in suitable patients with advanced TC.

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