Resection of mediastinal goiter extending to the carina with use of artificial pneumothorax, two-lung ventilation, and thoracoscopy, with the patient in a prone position

Abstract

A 67-year-old woman was presented with a mediastinal tumor extending from the left lobe of the thyroid and passing through the posterior trachea, causing displacement of the esophagus to the left side of the patient and then descending into the right side of the mediastinum to below the carina. Surgery was performed under two-lung ventilation with the patient in a prone position; general anesthesia was performed with a single-lumen tube combined with artificial pneumothorax. In thoracoscopic surgery, we were able to confirm and preserve anatomical structures. After detachment of the tumor at the level of the left and right subclavian arteries, the patient was placed supine, a cervical incision was added, and the tumor was extracted. The tumor was diagnosed as a nonmalignant mediastinal goiter (MG). No such surgical report was found in the literature, and one would be useful for this new approach to MG removal.

Effect of budesonide aerosol inhalation on postoperative complications and foreign body sensation in the throat of goiter resection patients

“…Goiter is found mostly among female patients, and it is generally treated with surgical resection in the clinic. However, patients experience throat discomfort and foreign body sensation caused by the intraoperative intubation of general anesthesia, and even suffer from more serious postoperative complications, leading to a greatly reduced operative effect [1][2][3]. Aerosol inhalation of glucocorticoids is an important means of relieving throat inflammation.…”