抽象的

Can more invasive procedures be avoided in patients with intrathoracic goitre? Patients with intrathoracic goitre and surgery

Menduh Oruc, Funda Oz, Atilla Durkan, Refi Ulku

Objective: We aimed to evaluate whether patients require an incision other than the neck incision before thyroid surgery.

Methods: We analysed data from 30 patients who underwent surgery for retrosternal goitre in our clinic between January 1996 and May 2017. We evaluated patient age, sex, physical examination findings, laboratory results, the surgical technique used, and complications. We used radiography, neck ultrasonography, and thoracic Computed Tomography (CT) to diagnose retrosternal goitre. All patients underwent fine-needle aspiration biopsy and those who were euthyroid underwent surgery. We examined postoperative morbidity, complications, and the duration of hospitalisation.

Results: This study involved 30 patients (23 females, 7 males; average age, 44 y (range: 32-69 y)). One undiagnosed event appeared as an intrathoracic mass on thoracic CT; sternotomy was performed and postoperative examination revealed thyroid pathology. Three patients underwent surgery that began with a collar incision and involved complete sternotomy, and three patients underwent partial sternotomy. The duration of hospitalisation for patients in whom the collar incision was sufficient was about 3 d; in cases of partial sternotomy, it was 5 d. The duration of hospitalisation in cases of complete sternotomy was 5.2 d. Infection occurred in three patients and haemorrhage occurred in two patients in the neck incision area; there were no deaths. According to postoperative pathological examination, one patient had Hashimoto’s thyroiditis and all other patients had multinodular goitre.

Conclusions: Median Sternotomy (MS) is not necessary in all cases of intrathoracic goitre that extend beyond the thoracic inlet. Thorough preoperative evaluation and good surgical planning are required to avoid unnecessary MS.