Transcervical Approach for Mediastinal Mass Originated from Thyroid Gland: An Alternative Surgical Option Using Ballooning Catheter.
- Author:
Jandee LEE
1
;
Chee Young LIM
;
Kee Hyun NAM
;
Jong Ho YOON
;
Hang Seok CHANG
;
Woong Youn CHUNG
;
Cheong Soo PARK
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. ysurg@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Trans-cervical approach;
Mediastinal mass;
Substernal goiter;
Ballooning catheter
- MeSH:
Carcinoma, Papillary;
Catheters*;
Fingers;
Follow-Up Studies;
Goiter, Substernal;
Hospitalization;
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Prognosis;
Recurrence;
Sternotomy;
Thyroglobulin;
Thyroid Gland*;
Thyroid Neoplasms;
Traction
- From:Journal of the Korean Surgical Society
2006;70(1):30-36
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aims of this study were to introduce an alternative surgical technique using a ballooning catheter and assess the outcomes of its use in patients with an upper mediastinal mass originated from the thyroid gland. METHODS: Between May 2001 and April 2004, 8 patients undewent an operation via a cervical approach using a ballooning catheter were enrolled in this study. The study group was reviewed by their clinical characteristics, diagnostic methods, postoperative results, histopathological findings and prognosis. Instead of a sternotomy, a ballooning catheter technique was used to assist in the transcervical delivery and extraction of these huge or deep mediastinal masses. The ballooning catheter was placed at the base of the mediastinal mass via a narrow plane which could not be reached by the surgeon's fingers. When the mediastinal mass was freed up by careful dissection with traction using an inflated ballooning catheter, could the mass was able to be delivered without injury to the surrounding tissues. RESULTS: There were 3, 2 and 3 cases of substernal goiters, substernal goiters combined with a papillary microcarcinoma and metastatic papillary carcinoma from thyroid cancer, respectively. The mean operation time and period of hospitalization were 121 minutes, (ranging from 70 to 195 minutes), and 6 days, (ranging from 3 to 10 days), respectively. In the 5 cases with a substernal goiter, the average size of the resected specimen was 9.9 cm, (ranging from 5.5 to 17.6 cm), with an average weight of 100.2 g, (ranging from 45 to 172.2 g). In the 3 cases of metastatic mediastinal lymph nodes, the postoperative 131I scan and serum thyroglobulin level showed no evidence of remnant metastatic tissue or cancer spillage. The median follow up duration was 24.8 months (ranging from 13 to 42 months). No major complications were documented, and no evidence of recurrence was encountered. CONCLUSION: The use of the ballooning catheter was found to be helpful in the transcervical removal of an upper mediastinal mass, and useful for substernal goiters. Furthermore, for mediastinal lymph node metastasis, this technique can be adopted as an alternative method in carefully selected cases.
