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[Substernal goiter: personal experience].

Pietro Giorgio Calò1, Alberto Tatti, Stefania Farris

  • 1Università degli Studi di Cagliari, Dipartimento di Chirurgia, Policlinico Universitario Monserrato, U.O. Chirurgia Generale. pgcalo@vaxca1.unica.it

Annali Italiani Di Chirurgia
|March 23, 2006
PubMed
Summary

Surgical treatment of substernal goiter is feasible with a cervical approach in most cases. When needed, sternotomy offers better control for difficult dissections, ensuring minimal morbidity.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Substernal goiters represent a significant portion of thyroid disease surgeries.
  • Accurate anatomical assessment is crucial for surgical planning.

Purpose of the Study:

  • To report on the surgical experience with substernal goiters.
  • To evaluate the safety and efficacy of different surgical approaches.

Main Methods:

  • Retrospective analysis of 222 patients with substernal goiters (1972-2004).
  • Surgical approaches included cervical, sternotomy, and thoracotomy.
  • Procedures involved subtotal and total thyroidectomy.

Main Results:

  • Cervical approach used in 213 cases; sternotomy in 7; thoracotomy in 2.

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  • Complications included hypoparathyroidism (4%), recurrent laryngeal nerve palsy (2.2%), and bleeding (1.8%).
  • No intraoperative mortality was observed.

    • Conclusions:

    • Total thyroidectomy via cervical approach is often sufficient.
    • Partial sternotomy aids in managing difficult dissections and protecting the recurrent laryngeal nerve.
    • Thoracotomy is rarely indicated for substernal goiter surgery.