Posterior Mediastinal Goiter

Chong, C. L.; Cheah, Wei-Keat; Sin, Fai-Lam; Wong, P. C.

doi:10.1177/021849230401200319

Cited by 13 publications

(13 citation statements)

References 5 publications

(19 reference statements)

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“…In addition, there is evidence showing that the age of <40 years and multiple nodules are the risk factors of recurrence after subtotal thyroidectomy, and thus total thyroidectomy is recommended for patients with bilateral multinodular goiter aiming to prevent a second surgery due to recurrence14. For patients with goiter in the posterior mediastinum, an incision is usually made in the neck and chest followed by total thyroidectomy 18.…”

Section: Discussionmentioning

confidence: 99%

Peri-Operative Treatment of Giant Nodular Goiter

Gao¹,

Tian²,

Jiang³

et al. 2012

Int. J. Med. Sci.

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Objective: To summarize the experience in the peri-operative treatment of giant nodular goiter.Methods: A total of 123 patients with giant nodular goiter sized 6~20 cm were admitted into our hospital from 1990 to 2011 and the clinical data were retrospectively analyzed. These patients underwent total or subtotal thyroidectomy.Results: All patients underwent surgical intervention. Unilateral subtotal thyroidectomy was performed in 40 patients, unilateral total thyroidectomy in 1 patient, bilateral subtotal thyroidectomy in 79 patients, and unilateral total thyroidectomy, removal of entire isthmus and contralateral subtotal thyroidectomy in 3 patients. Nodular goiter was pathologically proven post-operatively. No short-term complications such as dyspnea or thyroid storm were found postoperatively. Post-operative follow up was done for 9 months to 6 years and no recurrence was observed.Conclusion: Comprehensive pre-operative preparation, pre-operative evaluation, complete exposure of the operative field, meticulous operation, effective control and prevention of hemorrhage and prevention against damage to superior and recurrent laryngeal nerves are crucial for the successful surgical intervention of giant nodular goiter.

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Section: Discussionmentioning

confidence: 99%

Peri-Operative Treatment of Giant Nodular Goiter

Gao¹,

Tian²,

Jiang³

et al. 2012

Int. J. Med. Sci.

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“…According to various data the frequency of malignant neoplasms in intrathoracic goiter is estimated to 3-20% (9, 11). In case of doubts with the diagnosis of the intrathoracic goiter there is an indictaion for extended diagnostics with biopsy requiring videothoracoscopy, VATS (video assisted thoracic surgery) or mediastinoscopy (7).…”

Section: Discussionmentioning

confidence: 99%

“…The vast majority of intrathoracic goiters (up to 70%) can be resected through cervical access (7,15). It should be taken into consideration that in the remaining 30% of cases sternotomy or thoracotomy may be necessary.…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated that goiter may constitute from 10% to 15% of all tumours of mediastinum. In most cases (75-95%) it is located in anterior mediastinum, in front of major vessels and recurrent laryngeal nerves (5,6,7). In other cases goiter may be located in posterior mediastinum, in retrotracheal or retroesophageal position.…”

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confidence: 99%

“…Sucha a goiter comprises about 4% of tumors of posterior mediastinum and 10-25% of all cases of intrathoracic goiters. The majority of cases of goiter in posterior mediastinum is located on the right side, what probably is a result of pushing that way the goiter descending from the neck by the aortic arch and major vessels (6,7). Despite the presence of pathological mass in the madiastinum, up to 40% of patients show asymptomatic course.…”

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confidence: 99%

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Intrathoracic Thyroid Goiters

Jabłoński¹,

Wawrzycki²,

Brocki³

et al. 2010

Polish Journal of Surgery

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In this article, the difficulties in treatment of 18 patients with intrathoracic thyroid goiters were discussed. the aim of the study were: defining the etiology and symptomology of goiters within the chest in the own material, conducting the analysis of the diagnostic efficiency, the evaluation of the early results of surgery and postoperative complications. material and methods. The research material included 18 patients with intarhoracic thyroid goiters after surgical treatment (mediastinal goiters, ectopic goiters). The cases of retrosternal goiters were not analyzed. There was carried out the retrospective analysis of the medical documentation of goiters etiology, the frequency of dominating clinical symptoms, value of diagnostic methods, early effects of surgical treatment and postoperative complications. Results. In the years 2004-2008, operations were performed on 14 women and 4 men with intrathoracic goiters, aged from 34 to 82. The average age of patients was 51.1. The etiology of intrathoracic thyroid goiters were as follows: thyroid goiters (struma nodosa) -55%, adenoma and thyroid goiters -17%, thyroid cancer (ca papillare) and thyroid goiters -11%, ectopic thyroid gland -11%, thyroid goiters and thyroid inflammation -6%.The majority of the material were cases of a cervico-mediastinal thyroid gland, only 2 patients were diagnosed with an ectopic thyroid gland located in the mediastinum with no connection with the cervical thyroid. The local symptoms of compression on intrathoracic organs were mostly observed in the clinical picture, 22% of patients were asymptomatic. The diagnostic process included the estimation of the hormonal state and the radiology localised methods among which helical computer tomography was the most valuable. In order to estimate endotracheal intubation conditions 11 patients (61%) underwent brochofiberoscopy. The following accesses were used in the treatment: cervical -3 cases, partial sternotomy -11, longitudinal sternotomy -2, thoracotomy -1, combined thoracotomy with cervicotomy -1. Good treatment results were obtained in all cases. The following complications were noted: a permanent paralysis of the laryngeal nerve -1 case (6%), hypoparathyroidism -1 (6%). conclusions. Thyroid goiters situated inside the chest are a rarely met pathology which may cause serious difficulties in surgical treatment. Patients with this illness require a thorough preparation for the treatment including balancing hormonal perturbations, preventing intubation difficulties and access to the necessary quality of a diagnostics wit purpose of planning the most optimal surgical access and avoiding serious perioperative complications.

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Surgical approach to the intrathoracic goiter

Vaiman

Bekerman

Jabarin

et al. 2018

Laryngoscope Investig Oto

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ObjectiveIn a retrospective study, the authors analyzed the surgical approach to the intrathoracic goiter to avoid sternotomy or thoracotomy.MethodsWe selected 70 intrathoracic cases of multinodular goiter out of 988 cases of thyroidectomy and compared them with cervical goiter cases. Surgical technique, results, and postsurgical complications were assessed.ResultsThe analyzed cases presented the retrosternal goiter (n = 53; 75.7%), the retrotracheal goiter (n = 9; 12.8%), and the retroesophageal goiter (n = 8; 11.4%). Complaining of chest pressure or discomfort was specific for intrathoracic cases (50%; 35 of 70). All goiters except one were removed via cervical incision. The surgeons used head reclination and isthmus dissection when removing sizable goiters. Mean weight of goiters was 180 g. The recurrent laryngeal nerve was more often temporarily damaged in intrathoracic cases in comparison with cervical cases (4.3% vs. 2.8%, P = .04), but the difference in permanent injury was less significant (P = .09). The incidence of temporary hypoparathyroidism was significantly higher in intrathoracic cases (P = .01).ConclusionIn cases of multinodular goiter the goiters of various extensions can be successfully removed via the cervical incision in most of the cases even if they occupy the retrosternal, retrotracheal, or retroesophageal position. The transthoracic approaches and sternotomy might be justified in malignant cases.Level of Evidence4.

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Posterior Mediastinal Goiter

Cited by 13 publications

References 5 publications

Peri-Operative Treatment of Giant Nodular Goiter

Peri-Operative Treatment of Giant Nodular Goiter

Intrathoracic Thyroid Goiters

Surgical approach to the intrathoracic goiter

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