Surgical thinking about a cervical approach to remove a huge goiter behind the sternum
10.16066/j.1672-7002.2024.09.002
- VernacularTitle:颈部入路切除颈胸骨后巨大甲状腺肿的手术思考
- Author:
Lifen WANG
1
;
Zhichun HUANG
;
Yinjuan DU
Author Information
1. 东南大学附属中大医院耳鼻咽喉头颈外科,江苏 南京 210009
- Keywords:
Goiter,Substernal;
Thyroidectomy;
Surgical Procedures,Operative;
posterior sternum
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2024;31(9):549-553
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the surgical approach and method for treating giant sternal goiter through the neck. METHODS A retrospective analysis was conducted on the clinical data of 31 patients with massive retrosternal goiter admitted to the Department of Otolaryngology Head and Neck Surgery at Southeast University Affiliated Zhongda Hospital from January 2016 to December 2022. RESULTS All patients underwent complete tumor resection through a low neck neck incision,with an average surgical time of 131.64 minutes and an average blood loss of 80 ml. Surgical methods:Total thyroidectomy in 18 cases,left lobe and isthmus resection in 9 cases,and right lobe and isthmus resection in 4 cases. Two cases were transferred to the intensive care unit for transition after surgery,and the remaining 29 cases were all returned to the general ward;No deaths have occurred;Postoperative pathology:The postoperative pathological types were nodular goiter in 21 cases,papillary thyroid carcinoma in 4 cases,follicular thyroid tumors in 2 cases,follicular thyroid carcinoma in 2 cases,large B-cell lymphoma in 1 case,and thyroid borderline tumor in 1 case. Follow up for 6 months to 3 years,with no recurrence cases. CONCLUSION The surgical treatment of huge thyroid nodules behind the sternum through the cervical approach requires thorough preoperative evaluation,understanding of surgical indications,and the use of a low neck incision. During the operation,the main blood vessels supplying the thyroid gland are gradually ligated,separated,and the huge thyroid nodules are pulled out from behind the sternum,successfully and completely removed from the neck,avoiding open chest surgery,reducing the occurrence of related complications,and shortening the patient's course of illness.
