Symptoms, malignancy, overall morbidity, hypoparathyroidism, RLN palsy and hematoma are increased in cases of substernal goiter.

No abstract

ACs of the lung are malignant neuroendocrine tumours with a worst outcome in patients over 70 years and in smokers. With the exception of pneumonectomy, the extent of resection does not seem to affect survival and should be accompanied preferably by lymphadenectomy. Pathological staging, along with a mitotic index more than Ki-67 (MIB1), appears to be the most significant prognostic factor at the univariate analysis.

Surgical treatment of TOF is associated with good results in terms of control of acute symptoms and long-term outcome, particularly concerning oral intake and spontaneous breathing.

Background:We report short and long-term results with the dedicated Synthes ® titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. Results: Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV 1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. Conclusions: An optimal chest wall stabilization and reconstruction was achieved with the Synthes ® titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long-term restoration of a normal respiratory function was achieved, with minimal plates-related morbidity and chest pain. IntroductionChest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. The thoracic surgeon often has to deal with neoplastic, traumatic and malformative diseases affecting the chest wall and requiring the demolition and reconstruction or stabilization of the thoracic cage. For this purpose, many techniques have been proposed, including the use of various and different materials, but to date there are still no clear guidelines in the management of chest wall diseases.About 5 years ago, in 2010, a new dedicated titanium plates system (Synthes ® ) was introduced for the treatment of chest wall diseases and is nowadays available in the current practice of the thoracic surgeon (1,2). However, to the best of our knowledge, just one study about long-term outcome of patients in whom these plates were implanted, and only for post-traumatic chest wall stabilization, has been published (3). In our retrospective study we report short and long-term results obtained with this new system for the stabilization and reconstruction of the chest wall in neoplastic, traumatic and malformative diseases. Materials and methodsFrom January 2010 to December 2014, 27 consecutive patients (22 males, 5 females), with a median age of 60 years (range: 16-83 years), were treated with the dedicated Synthes ® titanium system (plates, splints and screws) for sternum and ribs reconstruction and stabilization (Synthes ® , Solothurn, Switzerland). In particular, we used both the dedicated sternal system (Sy...