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Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter
Cédric Nesti1, Benny Wohlfarth1, Yves M Borbély1
1Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
Frontiers in Surgery
|June 28, 2021
Summary
Surgical resection of retrosternal goiters (RSG) can be challenging. A refined thoracoscopic-assisted cervical approach offers a minimally invasive option for complex RSG cases, improving patient outcomes.
Area of Science:
- Endocrinology
- Thoracic Surgery
- Surgical Oncology
Background:
- Retrosternal goiters (RSG) often require surgical resection for symptom relief and malignancy exclusion.
- While a cervical approach is common, some RSG necessitate extracervical techniques like sternotomy or thoracoscopy.
- Posterior mediastinal extension (PME) presents unique surgical challenges.
Observation:
- A novel thoracoscopic-assisted cervical two-team approach was employed for a large RSG with PME and extensive vascularization.
- The technique involved cervical mobilization and gentle tumor manipulation through the thoracic inlet, avoiding extensive mediastinal dissection.
- Resection was completed via the cervical access, facilitating safe visualization and division of feeding vessels.
Findings:
- This refined technique is suitable for RSG with PME, provided the anteroposterior dimension is less than the thoracic inlet.
- It is indicated when a purely cervical approach is not feasible.
- The described method allows for safe resection of challenging retrosternal goiters.
Implications:
- This minimally invasive approach promises faster patient recovery and reduced postoperative pain.
- It is associated with decreased morbidity, shorter hospital stays, and improved cosmetic outcomes.
- This technique offers a valuable alternative for managing complex retrosternal goiters.
