Does a combined procedure for cardiac surgery and thyroidectomy offer acceptable outcomes?

Area of Science:

• Cardiothoracic Surgery
• Endocrine Surgery
• Evidence-Based Medicine

Background:

• Large retrosternal goiters can necessitate surgical intervention, sometimes in patients requiring cardiac surgery.
• The safety and efficacy of combining thyroidectomy with cardiac surgery for these patients are not well-established.

Purpose of the Study:

• To evaluate the outcomes of performing thyroidectomy for large retrosternal goiters concurrently with cardiac surgery in adult patients.

Main Methods:

• A structured literature search identified 16 relevant papers (3 Level 4 studies, 13 case reports) from 150 initial articles.
• Data on study type, patient demographics, intraoperative, and postoperative outcomes were tabulated for a cohort of 32 patients.

Main Results:

• Twenty-nine of 32 thyroidectomies were performed immediately before cardiac surgery.
• Post-procedural complications occurred in 8 patients, including transient recurrent laryngeal palsy and tracheomalacia.
• One intraoperative death was reported; however, all patients were euthyroid on follow-up.

Conclusions:

• Combined thyroidectomy and cardiac surgery for large retrosternal goiters in adult patients can be performed with good outcomes.
• While complications can occur, the overall results suggest this combined approach is a viable option.