Surgical Treatment of Retrosternal Goitre

Welman, Kiera; Heyes, Richard; Dalal, Paras; Hough, Sarah; Bunalade, Marciano; Anikin, Vladimir

doi:10.1007/s12070-017-1151-0

Cited by 5 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The decision to perform sternotomy should be considered carefully and discussed with the patient preoperatively because there is increased morbidity associated with sternotomy or thoracotomy. Patients requiring opening of the chest will have increased pain, respiratory complications and dehiscence of sternotomy as disastrous outcomes (12,13). In addition a large scar in the chest will be psychologically disturbing especially in the young.…”

Section: Introductionmentioning

confidence: 99%

A review of surgical management of retrosternal goitre in a single tertiary care referral centre in Sri Lanka

Silva¹,

Niyaz²,

Udupihilla³

et al. 2022

Galle Med J

View full text Add to dashboard Cite

Introduction: Retrosternal goitres require surgical removal due to compressive symptoms as well as risk of malignancy. In a majority, the retrosternal part can be removed through the neck incision, while 5-10% requiring a sternotomy. An alternative to sternotomy is thoracoscopy, which is associated with reduced morbidity. Methods:The surgical approach used to resect retrosternal goiters in our unit over a period of two years was evaluated. Results:In fifty four patients out of sixty (90%) with retrosternal extension, resection was feasible from neck. Out of the remaining six, two had median sternotomy while four had thoracoscopy. The operating time, blood loss, post-operative analgesic requirement and hospital stay were less in the thoracoscopy group.Conclusions: Majority of retrosternal goitres can be removed via neck. For those who require access in to chest, thoracoscopy is associated with reduced morbidity and hospital stay, when compared to median sternotomy.

show abstract

Section: Introductionmentioning

confidence: 99%

A review of surgical management of retrosternal goitre in a single tertiary care referral centre in Sri Lanka

Silva¹,

Niyaz²,

Udupihilla³

et al. 2022

Galle Med J

View full text Add to dashboard Cite

show abstract

“…Substernal goiter is usually involved within the anterior mediastinum while accounting for 10%-15% within the posterior one. The surgical approach is a curative treatment in the case of symptomatic substernal goiter, preventing potentially fatal symptoms of compressions [ 2 ]. Fundamentally, the way of surgical approach to a substernal goiter is principally decided based on the availability of easy and appropriate access to the mediastinum, considering the vital organs on the basis of the findings of relevant multiplanar cross-sectional imaging(s).…”

Section: Introductionmentioning

confidence: 99%

Sutureless Total Thyroidectomy for Substernal Goiter: Amending Versus Unnecessary

Aydin

Şengül

2021

Cureus

View full text Add to dashboard Cite

Substernal goiter is an enlarged thyroid gland, harboring a component extending into the mediastinum. Surgical management requires genuine and rigorous preoperative planning as physicians could encounter the prospect of the gland coming into close quarters with the vital intrathoracic structures. The neck and chest multiplanar cross-sectional imaging provide essentialness of an extracervical approach for the procedure. In the present study, a 57-year-old female who admitted with the intermittent dyspnea and dysphagia with a huge goiter is reported. The labs were reported within the normal limits and the video laryngoscopy displayed no pathologic finding. Her neck sonography revealed the multiple nodules within the gland, without determining the most proximal border of the left lobe. The neck and chest computed tomography depicted a substernal goiter harboring the left lobe, extending till the left innominate vein and a sutureless total thyroidectomy by the collar incision without a median sternotomy was performed. We would recommend sutureless thyroidectomy for substernal goiter just considering to divide meticulously the superior thyroid arteries and veins separately and exploring the fibrous Ligament of Berry, that is, the true Ligament of Berry, with its safe relationship to the recurrent laryngeal nerve in Thyroidology.

show abstract

Tracheomalacia after thyroidectomy for retrosternal goitres requiring sternotomy– a myth or reality?

Sulaiman

Lutfi

Ikram

et al. 2021

annals

View full text Add to dashboard Cite

Introduction Tracheomalacia after thyroidectomy is not well understood. Reports on tracheomalacia are conflicting, with some suggesting a high rate and other large cohorts in which no tracheomalacia is reported. The aim of our study was to assess the incidence and factors associated with tracheomalacia after thyroidectomy in patients with retrosternal goitres requiring sternotomy at a high-volume tertiary care referral centre. Methods A longitudinal cohort study was conducted from January 2011 to December 2019. All adult patients who underwent thyroidectomy with sternotomy were included. Tracheomalacia was considered when tracheal rings were soft compared with other parts (proximal or distal) of the trachea and required either tracheostomy or resection with anastomosis. The decision to perform a tracheostomy or to administer continuous or bilevel positive airway pressure postoperatively was made depending on the degree of tracheomalacia. Logistic regression analysis was used to assess factors associated with tracheomalacia. Results We evaluated 40 patients who underwent thyroidectomy with sternotomy. The mean age of our cohort was 48.7 ± 11.3 years and the population was predominantly female (67.5%). One patient required tracheal resection with anastomosis, and two patients required tracheostomy. Multivariable logistic regression analysis did not reveal any patient- or thyroid-related factor significantly associated with the development of tracheomalacia in our cohort. Conclusions The incidence of tracheomalacia after thyroidectomy with sternotomy appears to be very low. However, the occurrence of tracheomalacia after thyroidectomy in cases of large goitre is possible and hence worrisome.

show abstract

Surgical Treatment of Retrosternal Goitre

Cited by 5 publications

References 15 publications

A review of surgical management of retrosternal goitre in a single tertiary care referral centre in Sri Lanka

A review of surgical management of retrosternal goitre in a single tertiary care referral centre in Sri Lanka

Sutureless Total Thyroidectomy for Substernal Goiter: Amending Versus Unnecessary

Tracheomalacia after thyroidectomy for retrosternal goitres requiring sternotomy– a myth or reality?

Contact Info

Product

Resources

About