SURGICAL TREATMENT OF CHEST GOITER
https://doi.org/10.17238/issn2072-3180.2021.1.54-58
Abstract
Introduction. This article describes the clinic and diagnosis of retrosternal goiter and methods of surgical treatment.
Materials and methods. The aim of this study was to identify preoperative predictors of sternotomy in the treatment of retrosternal goiter. In the period from 2012 to 2019 in clinic were hospitalised 820 patients. Of these, 48 (5.8%) had a retrosternal goiter and were included in the study. The age of patients varied from 48 to 75 years, the average age was 49.8 years. There were 8 men (16.7%) and 40 women (83.3%). All retrosternal goiter were surgically treated with 44 (91.7%) cervical accesses and 4 (8.3%) sternotomy. The essence of the technique is to ensure maximum mobility of the removed share with the chest component when mobilizing it from top to bottom. The diagnosis was made by chest x-ray, thyroid ultrasound, CT and MRI, as well as thyroid scintography. All patients were given clinical, biochemical analyses and coagulogram.
Results. All operations were successful, without serious postoperative complications. Unknown postoperative complications of transient hypocalcemia and transient paralysis of the recurrent laryngeal nerve occurred in 6 (12.5%) and 2 (4.2%). An indication for the average stereotomy was the extension of the goitre below the aortic arch, a large thyroid tissue, extending to the bifurcation of the trachea and ectopic thyroid tissue in the mediastinum.
Conclusions. The retrosternal goiter can be removed through a neck incision, but in rare cases a median sternotomy may be required.
About the Authors
M. M. Magomedov
FSBEI Dagestan State Medical University
Russian Federation
Russian Federation
Magomedov Mukhuma Magomedovich, Professor of the Department of surgery of FPC and PPS with the course of endoscopic surgery
367003, Makhachkala, 1 Abdulla Aliev Street
O. M. Osmanov
Clinical City Hospital 67
Russian Federation
Russian Federation
Osmanov Omar Magomedtagirovich, PhD (Med)
Salama Adil str., 2/44, 123423, Moscow
References
1. Akbarov M.M., Pаkhomov G.L., Khayaliev R.Ya., Orzikulov E.I. Sovershenstvovanie diagnostiki i hirurgicheskogo lecheniya zagrudinnogo zoba. [Improvement of diagnostics and surgical treatment of retrosternal goiter]. Young scientist, 2015, No. 7 (87), pp. 249–250. (In Russ.)
2. Mikhailichenko V.Yu., Karakursakov N.E., Shestоpalov D.V., Old A.A. Sluchaj shejno-zagrudinnogo zoba s kompressiej verhnej poloj veny [A case of cervico-retrosternal goiter with compression of the superior vena cava]. International Journal of Applied and Fundamental Research, 2016, No. 3, pp. 352–354. (In Russ.)
3. Romanchishen A.F. Hirurgiya shchitovidnoj i okolo shchitovidnyh zhelez [Surgery of the thyroid and thyroid glands]. SPb: IPK “Vesti”, 2009, 566 p. (In Russ.)
4. Malvemyr P., Liljeberg N., Hellstrom M., Muth A. Computed tomography for preoperarive evaluation of need for sternotomy in surgery for retrosternal goiter. Langenbecks Archives `of Surgery, 2015, 400, pp. 293–299.
5. Cohen J.P. Substemal goiters and sternotomy. Laryngoscope, 2009, 119 (4), pp.683–688.
6. Fabrizio S., Federico A., Panagioris P. et.al. Is sternotomy always necessary for the treatment of mediatinal ectopic thyroid goiter? Ann. Ital. Chir., 2014, 8, pp. 304–307.
7. Rugiu M.G., Piemonte M. Surgical approach to retrosternal goitre: do we still need sternotomy? Acta Otorhinolaryngol Ital., 2009, 6, pp. 331–338.
8. De Perrot M., Fadet E., Mercier O., Farhamand P., Fabre D., Mussot S. et al. Surgical management of Wediastinal goiters: when is a sternotomy required? J. Thorac. Cardiovasc. Surg., 2007, 55 (l), pp. 39–43.
9. Magomedov M.M., Aydynbekova Z. T. Zabolevanie shchitovidnoj zhelezy i ee oslozhneniya [Thyroid disease and its complications]. Makhachkala: “Lotos”, 2020, 149 р. (In Russ.)
10. Rolighed L., Ronning H., Christiansen P. Sternotomy for substernalgoiter: retrospective study of 52 operations. Langenbeсks Archives of Surgery, 2015, 400, pp. 301–306.
11. Chen A. Y., Bernet V.T., Charty S.E., Davies T.F., Ganly I., Inabnet W.B. & Shaha A.R. American Thyroid Association Statement on Optimal Surgical Management of Goiter. Thyroid., 2014, 24, pp. 181–189.
Review
For citations:
Magomedov M.M., Osmanov O.M. SURGICAL TREATMENT OF CHEST GOITER. Moscow Surgical Journal. 2021;(1):54-58. (In Russ.) https://doi.org/10.17238/issn2072-3180.2021.1.54-58
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