Papillary Carcinoma of Thyroid
Background
A 55 year old woman presented with complaint of hoarseness of voice since 3 months. On clinical examination, a small 2 x 1 cm nodule was seen involving the right lobe of thyroid.
Diagnosis and Treatment
Total thyroidectomy and Central Compartment lymph node dissection was done, during which a cuff of esophagus muscle was removed with a small breach in mucosa. Mucosal defect was closed primarily, whereas muscular defect was oversewn with sternothyroid muscle as the esophageal muscle defect was not suitable for primary closure. Post operatively the patient was kept on nasogastric feeds for 2 weeks. Gastrograffin swallow was done after 2 weeks and it showed no evidence of leak and free flow of contrast into the stomach.
Follow up gastrogaffin study showing free flow of contrast
Intra operative image showing esophagealmuscle defect repaired with sternothyroid muscle
Conclusion
Here we describe another method of esophageal repair using inferiorly based sternothyroid muscle, owing to the close proximity of this muscle to the cervical Esophagus. It could be a reasonable alternative for non-circumferential upper Esophageal muscle defect which cannot be sutured primarily.
About Author –
Dr. K. Sreekanth, Consultant Surgical Oncologist, Yashoda Hospital, Hyderabad
MS, M.Ch (Surgical Oncology)
