Abstract
Retrosternal goiters (RSGs) can be removed transcervically but additional incisions are sometimes necessary. We planned the factors determining the need for additional incisions to remove an RSG goiter based on our experience and on an algorithm.
Between 2006-2013 additional incisions were needed in 20 patients with RSG in whom collar excision was not successful. Partial sternotomy was performed in 5 patients, total sternotomy in 13 and thoracotomy in 2. Vocal cord paralysis was detected in 1 patient at admission to the clinic and was occurred in 2 patients due to the operation. Tracheal laseration was occurred in 1 patient due to the intubation. Resection could not performed to 1 patient after getting the frozen-section as medullary tiroid carcinoma. The final histopathologies were learned as adenomatous guatr in all patients in whom total tiroidectomy was applied.
Additional incisions can be made if thyroidectomy cannot be done transcervically and if the goiter extends to the level of the aortic arch. If the thyroid gland extends below the aortic arch and the lateral diameter of the goiter is greater than 10 cm, apartial sternotomy may be required. Total sternotomy is needed when an RSG extends caudally to the azygos vein, if it is located in the retrotracheal or retroesophageal space, or if it is recurrent or ectopic. Coexisting lung disorders and goiters extending to the left atrium also require thoracotomy.
- © 2014 ERS
