Management of Retrosternal Goiter without Sternotomy: A Retrospective Review in a Tertiary Care Center

Abstract

Background and aims: Retrosternal goiter (RG) is defined as a thyroid mass of which more than 50% is located below the thoracic inlet. It can give rise to various compression symptoms like dyspnea and dysphagia, which necessitate the need for surgery. The aim of this study is to review the management of patients with retrosternal extension of goiter through a neck collar incision without sternotomy with minimal morbidity at a tertiary care center. Materials and methods: A retrospective analysis of 224 patients who underwent thyroid surgery between January 2014 and August 2018, in

Mediastinal Goiter from the View of Thoracic Surgery

“…Regarding the demographics, the incidence of male: female was 1:4.25 with mean age of 57.1 years, which is like that published by Veerabhadraiah and his colleagues where the male: female ratio was 1:4.25 with mean age of 51 years while others like Varshney reported male: female incidence of 1:2.6 but the mean age was of 52 years (1,15) . Khairy et al (2) reported mean age of 54 years and the incidence of females was 3.3 times males.…”

“…RSG is reported in the literature to range from 3 to 20% of the patients undergoing thyroidectomy operation. This wide range in the incidence is mostly due to the different definitions given for RSG (1,15) . In our study we included only the cases with goiters extending deep in the mediastinum with more than of 50% of its main portion in the retrosternal region.…”

“…The mere presence of retrosternal goiter is not necessarily an indication for an additional extracervical approach but it may be required when retrosternal goiter is too large to be enucleated through thoracic inlet; the blood supply source is in the chest; retrosternal goiter extending into the mediastinum causes anatomic variations in the anatomy of the RLN and the parathyroid glands or the severe venous congestion that may cause severe bleeding or those extending beyond the aortic arch into the posterior mediastinum (15,17) .…”