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Updated: Dec 21, 2025

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
04:09

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Surgery for retrosternal goiter: cervical approach.

Xu Wang1,2, Yuqiu Zhou2, Chao Li2

  • 1Department of Clinical Medicine, Chengdu Medical College, Chengdu 610041, China.

Gland Surgery
|May 19, 2020
PubMed
Summary

Retrosternal goiter surgery is often safely managed via a cervical approach, even for substernal extensions. Careful preoperative CT evaluation and meticulous surgical technique minimize perioperative complications.

Keywords:
Retrosternal goitersurgerythyroid

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Area of Science:

  • Surgical Oncology
  • Endocrine Surgery
  • Thoracic Surgery

Background:

  • Retrosternal goiter involves thyroid tissue extending into the mediastinum, often causing compressive symptoms requiring surgical intervention.
  • This condition presents surgical challenges due to its substernal location.

Purpose of the Study:

  • To analyze surgical approaches for retrosternal goiter.
  • To evaluate perioperative complications associated with different surgical techniques.
  • To recommend optimal surgical strategies for retrosternal goiter management.

Main Methods:

  • Retrospective analysis of 115 patients with retrosternal goiter treated between May 2011 and March 2019.
  • Evaluation of patient characteristics, surgical methods, and perioperative complications.
  • Preoperative assessment primarily utilized CT imaging (85.22% of patients).

Main Results:

  • The cervical approach was used in 112 patients (97.39%), with only 3 requiring an extracervical approach.
  • Most patients (73.91%) were asymptomatic preoperatively, with tracheal compression often discovered intraoperatively or via imaging.
  • The most common complications included transient recurrent laryngeal nerve palsy (6.25% with cervical approach) and transient hypocalcemia (20.54% with cervical approach). No permanent complications or deaths were reported.

Conclusions:

  • Retrosternal goiter surgery can be safely performed using a cervical approach in most cases.
  • Preoperative CT evaluation is crucial for surgical planning.
  • Meticulous surgical technique and careful planning are key to successful outcomes and minimizing complications.