When is Transthoracic Approach Indicated in Retrosternal Goiters?

Purpose: It is critical to differentiate among pathologies of substernal thyroid gland diseases because surgical approaches (i.e., median sternotomy or thoracotomy) might also include a cervical incision. The aim of this study was to analyze the features of patients with goiter who underwent a thyro...

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Bibliographic Details
Published in:Annals of Thoracic and Cardiovascular Surgery 2011/06/25, Vol.17(3), pp.250-253
Main Authors: Kilic, Dalokay, Findikcioglu, Alper, Ekici, Yahya, Alemdaroglu, Utku, Hekimoglu, Koray, Hatipoglu, Ahmet
Format: Article
Language:English
Subjects:
Adult
Aged
Carcinoma - pathology
Carcinoma - surgery
Female
Goiter, Nodular - pathology
Goiter, Nodular - surgery
Goiter, Substernal - pathology
Goiter, Substernal - surgery
Humans
intrathoracic goiter
median sternotomy
Length of Stay
Magnetic Resonance Imaging
Male
mediastinal mass
Middle Aged
Sternotomy - adverse effects
substernal goiter
thoracotomy
Thoracotomy - adverse effects
Thyroid Neoplasms - pathology
Thyroid Neoplasms - surgery
Thyroidectomy - adverse effects
Thyroidectomy - methods
Thyroiditis - pathology
Thyroiditis - surgery
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Turkey
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Summary:Purpose: It is critical to differentiate among pathologies of substernal thyroid gland diseases because surgical approaches (i.e., median sternotomy or thoracotomy) might also include a cervical incision. The aim of this study was to analyze the features of patients with goiter who underwent a thyroidectomy via a cervical incision and a median sternotomy or thoracotomy. Methods: We reviewed 9 cases of thyroid disease in patients undergoing thoracic incisions with or without a cervical incision for varying indications between March 2003 and Jun 2009 were reviewed. Thyroidal masses were removed via a median sternotomy in six patients and thoracotomy in three patients. Split median sternotomy combining thoracotomy was performed in 1 patient. Cervical incision was added in all patients. Results: Pathologic examination revealed multinodular goiter in 5 patients, thyroid carcinoma in 3, and reidel thyroiditis in 1. All patients were extubated in the early postoperative period. There was no postoperative mortality or morbidity. The mean hospital stay was 8.6 days (range, 4-11 days), and mean follow-up was 24.3 months (range, 4-39 months). Conclusions: We recommend the use of transthoracic approaches, such as median sternotomy and thoracotomy for retrosternal goiter for surgical exposure, because they provide a wide exposure and facilitate removal of the mass. By using median sternotomy and thoracotomy, we can avoid catastrophic results, such as hemorrhage, as well as completely remove malignancies.
ISSN:1341-1098
2186-1005
DOI:10.5761/atcs.oa.10.01541