异种脱细胞真皮基质修复膜修复甲状腺癌切除术后气管缺损13例

doi:10.6040/j.issn.1673-3770.0.2015.248

山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (5): 52-54.doi: 10.6040/j.issn.1673-3770.0.2015.248

异种脱细胞真皮基质修复膜修复甲状腺癌切除术后气管缺损13例

徐增瑞¹, 张建新¹, 石继红¹, 蔡晓岚²

1. 天津市第四中心医院耳鼻咽喉头颈外科, 天津 300140;
2. 山东大学齐鲁医院耳鼻咽喉科, 山东济南 250012

收稿日期:2015-06-22 修回日期:2015-09-22 出版日期:2015-10-16 发布日期:2015-10-16
通讯作者: 蔡晓岚,E-mail:cxlsd@sdu.edu.cn E-mail:cxlsd@sdu.edu.cn
作者简介:徐增瑞,E-mail:szx_xzr@126.com

Repair of tracheal defect after resection of thyroid carcinoma with acellular dermal matrix membrane

XU Zengrui¹, ZHANG Jianxin¹, SHI Jihong¹, CAI Xiaolan²

1. Department of Otolaryngology & Head and Neck Surgery, Tianjin 4th Centre Hospital, Tianjin 300140, China;
2. Department of Otolaryngology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China

Received:2015-06-22 Revised:2015-09-22 Online:2015-10-16 Published:2015-10-16

摘要/Abstract

摘要： 目的探讨异种脱细胞真皮基质修复膜修复甲状腺癌切除术后气管缺损的可行性。方法甲状腺癌侵犯气管患者13例经甲状腺肿瘤切除、颈部淋巴结清扫、气管部分切除术,以异种脱细胞真皮基质修复膜修复气管缺损。结果术后随访36~53个月,11例患者气管腔无肉芽生长,管腔光滑,顺利拔管;2例拔管失败,气管内肉芽形成感染1例,气管修复处内陷1例。结论累及气管的甲状腺癌患者,可根据肿瘤切除后气管缺损范围,选择适当病例,以异种脱细胞真皮基质修复膜修复气管缺损,保障气道通畅。

关键词: 异种脱细胞真皮基质修复膜, 气管缺损, 甲状腺肿瘤, 组织修复

Abstract: Objective To explore the feasibility of using acellular dermal matrix membrane in tracheal defect repair after thyroid carcinoma resection. Methods Clinical data of 13 patients who suffered thyroid cancer involving trachea were retrospectively analyzed. All tracheal defects were repaired with heterogeneous acellular dermal matrix membrane. Results During the follow-up of 20 to 53 months, 11 cases removed tracheal tube smoothly, no granulation grew in trachea, and the lumen of repair site was smooth;2 cases failed to remove the tracheal tube, one of them developed infection of granulation, and the other had collapse of the repair site. Conclusion After resection of thyroid carcinoma involving the trachea, tracheal defect could be repaired by cellular dermal matrix membrane. Cases should be carefully selected in order to ensure the airway patency after operation.

Key words: Thyroid carcinoma, Repair, Acellular dermal matrix membrane, Tracheal defect

中图分类号:

R736.1

徐增瑞, 张建新, 石继红, 蔡晓岚. 异种脱细胞真皮基质修复膜修复甲状腺癌切除术后气管缺损13例[J]. 山东大学耳鼻喉眼学报, 2015, 29(5): 52-54.

XU Zengrui, ZHANG Jianxin, SHI Jihong, CAI Xiaolan. Repair of tracheal defect after resection of thyroid carcinoma with acellular dermal matrix membrane[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(5): 52-54.

参考文献

[1] American Joint Committee on Cancer. NCCN guidelines: Thyroid carcinoma[S]. Version, 3, 2011.
[2] Weir H K, Thompson T D, Soman A, et al. The past, present and future of cancer incidence in the United States: 1975 through 2020[J]. Cancer, 2015, 121:1827-1837.
[3] McCarty T M, Kuhn J A, Williams W L Jr, et al. Surgical management of thyroid cancer invading the airway[J]. Ann Surg Oncol, 1997, 4(5):403-408.
[4] Segal K, Abraham A, Levy R, et al. Carcinomas of the thyroid gland invading larynx and trachea[J]. Clin Otolaryngol Allied Sci, 1984, 9(1):21-25.
[5] Mellière D J, Ben Yahia N E, Becquemin J P, et al. Thyroid carcinoma with tracheal or esophageal involvement: limited or maximal surgery?[J]. Surgery, 1993, 113(2):166-172.
[6] 杭剑萍,孟东,李励琦,等.侵犯气管的甲状腺癌切除后锁骨头带蒂软骨修补术12例报告[J].中华普通外科杂志,2007,22(1):85-87. HANG Jianping, MENG Dong, LI Liqi, et al. Thyroid carcinoma invading the trachea: treatment by partial tracheal resection and repair using the pedicled cartilage of the clavicle head in 12 cases[J]. Chin J General Surgery, 2007, 22(1):85-87.
[7] 刘志,崔鹏程,陈文弦,等.喉气管重建术中支架材料的选择及应用效果[J].中国修复重建外科杂志,2011,25(5):551-553. LIU Zhi, CUI Pengcheng, CHEN Wenxian, et al. Application of various materials in reconstruction of laryngotracheal framework[J]. Chin J Reparative Reconstructive Surgery, 2011, 25(5):551-553.
[8] Balasubramanian D, Thankappan K, Shetty S, et al. Cricotracheal reconstruction with free radial forearm flap and titanium mesh[J]. Head Neck, 2013, 35(2):178-180.
[9] 李仕晟,李友忠,唐青来,等.侵犯气管的分化型甲状腺癌的外科处理及预后分析[J].中华耳鼻咽喉头颈外科杂志,2014,49(10):802-806. LI Shisheng, LI Youzhong, TANG Qinglai, et al. Management and prognosis of differentiated thyroid carcinoma with tracheal invasion[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2014, 49(10):802-806.
[10] Lin S, Huang H, Liu X, et al. Treatments for complications of tracheal sleeve resection for papillary thyroid carcinoma with tracheal invasion[J]. Eur J Surg Oncol, 2014, 40(2):176-181.
[11] 徐先发,李正江,王洵,等.高分化甲状腺癌侵犯喉气管的治疗及预后[J].中华医学杂志,2004,84(22):1888-1891. XU Xianfa, LI Zhengjiang, WANG Xun, et al. The management and prognosis of laryngotracheal invasion by well-differentiated thyroid carcinoma[J]. Nat Med J Chin, 2004, 84(22):1888-1891.

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异种脱细胞真皮基质修复膜修复甲状腺癌切除术后气管缺损13例

Repair of tracheal defect after resection of thyroid carcinoma with acellular dermal matrix membrane

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