STERNOTOMY REQUIREMENT IN RETROSTERNAL GOITER

Yıl 2019, , 261 - 265, 06.02.2020

Taygun Gülşen Mustafa Demir Yavuz Kurt Ahmet Balta

https://doi.org/10.5505/deutfd.2019.43650

Öz

Retrosternal goiter is a condition caused by cervical thyroid tissue reaching out to mediastinum or isolated embryological thyroid tissue in mediastinum. It can cause various compression symptoms when it reaches large dimensions. Between 2005 and 2019, 267 patients underwent total thyroidectomy for multinodular goiter. Six of them had retrosternal goiter. Collar incision was sufficient in three of these 6 patients. In two of the other three patients, partial sternotomy was performed in addition to collar incision. In one patient, in addition to the collar incision, partial sternotomy, anterior thoracotomy, and “J” neck incision were performed. We aimed to present these three patients in our article.

Anahtar Kelimeler

retrosternal goiter, sternotomy, thyroidectomy

Retrosternal guatrda sternotomi ihtiyaci

Öz

Retrosternal guatr servikal tiroit dokusunun mediastene uzanmasından veya mediasten içinde izole embriyolojik tiroit dokusu bulunmasından kaynaklanan bir durumdur. Büyük boyutlara ulaştığında çeşitli bası semptomlarına yol açabilir. Kliniğimizde 2005 ve 2019 yılları arasında 267 hastaya multinoduler guatr nedeniyle total tiroidektomi yapılmış olup bunların 6 tanesinde retrosternal guatr mevcuttu. Bu 6 hastanın üçünde Collar insizyon yeterli oldu. Diğer üç hastanın ikisinde Collar insizyona ek olarak parsiyel sternotomi yapıldı. Bir hastada ise collar insizyona ek olarak parsiyel sternotomi, anterior torakotomi ve boyundan j kesi yapıldı. Bu üç hastayı yazımızda sunmayı amaçladık.

Anahtar Kelimeler

retrosternal guatr, sternotomi, tiroidektomi

Kaynakça

• 1. Katlic MR, Wang C, Grillo HC. Substernal Goiter. Am Thorac Surg. 1985; 39(4): 391-9.
• 2. Ben Nun A, Soudack M, Best LA. Retrosternal Thyroid Goiter: 15 Years Experience. Isr Med Assoc J. 2006;8(2): 106-9.
• 3. Hedeyati N, McHenry CR. The clinical presentation and operative management of nodular and diffuse substernal thyroid disease. Am Surg. 2002;68(3):245-51.
• 4. Lin YS, Wu HY, Lee CW, Hsu CC, Chao TC, Yu MC. Surgical management of substernal goitres at a tertiary referral centre: a retrospective cohort study of 2,104 patients. Int J Surg. 2016;27:46 –52.
• 5. Coskun A, Yildirim M, Erkan N. Substernal goiter: when is a sternotomy required? Int Surg. 2014; 99:419 –25.
• 6. de Souza FM, Smith PE. Retrosternal goiter. J Otolaryngol. 1983;12:393–6.
• 7. Rios A, Rodriguez JM, Balsalobre MD, Tebar FJ, Parrilla P. The value of various definitions of intrathoracic goiter for predicting intra-operative and postoperative complications. Surgery. 2010;147(2):233–8.
• 8. Cannon CR, Lee R, Didlake R. Management of the substernal goiter: a team approach. J Miss State Med Assoc. 2010;51 (7):179 –82.
• 9. Flati G, Giacomo T, Porowska B, Flati D, Gai F, Talarico C, et al. Surgical management of substernal goitres. When is sternotomy inevitable? Clin Ter. 2005;156 (5):191 –5.
• 10. Machado NO, Grant CS, Sharma AK, Sabti HA, Kolidyan SV. Large posterior mediastinal retrosternal goiter managed by a transcervical and lateral thoracotomy approach. Gen Thorac Cardiovasc Surg. 2011;59 (7): 507–11.
• 11. Raffaelli M, de Crea C, Ronti S, Bellantone R, Lombardi C P. Substernal goiters: incidence, surgical approach, and complications in a tertiary care referral center,” Head&Neck. 2011;33 (10): 1420–25.
• 12. White ML, Doherty GM, Gauger PG. Evidence based surgical management of substernal goiter. World J Surg, 2008;32 (7): 1285–1300.
• 13. Testini M, Gurrado A, Avenia N, Bellantone N, Biondi A, Brazzarola P. Does mediastinal extension of the goiter increase morbidity of total thyroidectomy? A multicenter study of 19,662 patients. Ann Surg Oncol. 2011;18 (8):p. 2251–9.
• 14. Rolighed L, Ronning H, Christiansen P. Sternotomy for substernal goiter: retrospective study of 52 operations. Langenbeck's Arch Surg. 2015;400 (3):301–6.
• 15. Benbakh M, Abou-elfadl M, Rouadi S, Abada RL, Roubal M, Mahtar M. Substernal goiter: experience with 50 cases Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133(1):19–22.
• 16. Mercante G, Gabrielli E, Pedroni C. Formisano D, Bertolini L, Nicoli F, et al. CT cross-sectional imaging classification system for substernal goiter based on risk factors for an extracervical surgical approach. Head Neck. 2011;33(6):792–9.
• 17. Migliore M, Costanzo M, Cannizzaro MA. Cervicomediastinal goiter: Is telescopic exploration of the mediastinum (videomediastinoscopy) useful? Interact Cardiovasc Thorac Surg. 2010; 10(3): 439-440.
• 18. Al-Mufarrej F, Margolis M, Tempesta B, Strother E,Gharagozloo F. Novel thoracoscopic approach to posterior mediastinal goiters: Report of two cases. J Car-diothorac Surg 2008; 3: 55.
• 19. Podgaetz E, Gharagozloo F, Najam F, Sadeghi N, MargolisM, Tempesta B. A Novel Robot-assisted technique for excision of a posterior mediastinal thyroid goiter. Innovations (Phila)2009; 4(4): 225-228.