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Updated: Sep 29, 2025
04:09
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
439
Retrosternal Goitre: Anatomical Aspects and Technical Notes
Enrico Battistella1, Luca Pomba1, Gisella Sidoti1
1Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
Medicina (Kaunas, Lithuania)
|March 26, 2022
Summary
Cervicotomy is the preferred surgical approach for substernal goitre, offering a lower complication rate compared to combined or sternotomy approaches. This technique ensures safer and more effective management of intrathoracic goitres.
Area of Science:
- Surgery
- Endocrinology
- Thoracic Surgery
Background:
- Surgical management of substernal goitre remains debated due to diverse surgical options.
- This study reviews extensive experience with 264 cases of plunging goitre (goitre plongeant).
Purpose of the Study:
- To compare postoperative complications and length of stay for different surgical approaches to substernal goitre.
- To establish optimal surgical strategies for substernal goitre management.
Main Methods:
- Retrospective analysis of 264 patients with substernal goitre.
- Comparison of cervicotomy versus combined surgical access using Pearson chi-square test.
- Detailed description of preoperative planning and surgical techniques.
Main Results:
- Kocher incision (cervicotomy) was used in 96.6% of cases.
- Combined surgical access was associated with a significantly higher rate of postoperative complications (p < 0.01).
- Average length of stay was 2 days for cervicotomy versus 5 days for combined access (p=n.s.).
Conclusions:
- Cervicotomy with digital dissection is recommended as the gold standard for intrathoracic goitre.
- Sternotomy should be reserved for selected cases due to higher complication rates.
- Management in high-volume centers may improve outcomes.
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