Korean Journal of Head & Neck Oncology (대한두경부종양학회지)
- Volume 14 Issue 2
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- Pages.236-243
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- 1998
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- 1229-5183(pISSN)
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- 2586-2553(eISSN)
Clinical Studies on Locally Invasive Thyroid Cancer
국소침범한 갑상선암의 임상적 고찰
- Kim Young-Min (Department of Otorhinolaryngology, Hallym University College of Medicine) ;
- Lee Chang-Yun (Department of Otorhinolaryngology, Hallym University College of Medicine) ;
- Yang Kyung-Hun (Department of Otorhinolaryngology, Hallym University College of Medicine) ;
- Rho Young-Soo (Department of Otorhinolaryngology, Hallym University College of Medicine) ;
- Park Young-Min (Department of Otorhinolaryngology, Hallym University College of Medicine) ;
- Lim Hyun-Jun (Department of Otorhinolaryngology, Hallym University College of Medicine)
- 김영민 (한림대학교 의과대학 이비인후과학교실) ;
- 이창윤 (한림대학교 의과대학 이비인후과학교실) ;
- 양경헌 (한림대학교 의과대학 이비인후과학교실) ;
- 노영수 (한림대학교 의과대학 이비인후과학교실) ;
- 박영민 (한림대학교 의과대학 이비인후과학교실) ;
- 임현준 (한림대학교 의과대학 이비인후과학교실)
- Published : 1998.11.01
Abstract
Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with
1991년부터 1997년월까지 7년간 한림대학교 이비인후과학교실에서 국소침범한 갑상선암으로 치료를 받은 10명의 환자들을 후향적으로 검토하여 다음과 같은 결과를 얻었다. 1) 성별 분포는 남녀비는 1:2.3이었으며 연령별 분포는 60대 이상이 7명으로 노인에 호발함을 알 수 있었다. 2) 임상승상은 애성이 5례(50%)로 가장 많았으며 무증상이면서 경부종괴로 온 경우가 3례 그외에 연하곤란, 호흡곤란 객혈 등이었다. 3) 침범된 구조는 기관 7례, 반회후두신경과 종격동임파절이 각각 5례, 경부식도 3례, 경동맥 3례, 기관주위임파절 3례, 하인두 1례, 미주신경 1례 순이었다. 4) 침범된 구조물들에 대한 수술로는 기관 수상절제술 및 단단문합술이 1례. 기관 수상절제와 윤상기관성형술 1례, 기관 창절제술 및 일차봉합술 1례. 기관 창절제술 및 흉쇄유돌근-근막피판재건술 1례, 기관 면도식절제술 1례, 식도 부분절제술 2례, 식도 면도식절제술 1례, 편측 윤상후두절제술 1례, 윤상연골 부분절제술 및 흉쇄유돌근-근골막피판재건술 1례, 갑상연골 면도식절제술 1례, 반회후두신경절제술이 2례, 미주신경절제술 1례, 경동맥절제술 및