[Surgical treatment of large goiters extending into the retrosternal space]

The authors describe the characteristics of primary and secondary goitres reaching as far as the retrosternal space. 154 operations of retrosternal goitres during a five-year period account for 16.7% of all operations of the thyroid gland. The great majority (97.4%) of operations was made from a cervical approach. The authors express also their opinion on sternotomies in these operations; the reasons comprise also extensive goitres which cannot be removed across the upper thoracic aperture where the orientation on the position of major blood vessels is poor, when local invasion of the tumour into the neighbouring tissues is suspected, in some reoperations or when it is necessary to explore the mediastinum to differentiate other lesions. The very rare thoracotomic approach is reserved for large retrosternal goitres located in the posterior mediastinum.