Predictors of Airway Complications After Thyroidectomy for Substernal Goiter

Shen, Wen T.; Kebebew, Electron; Duh, Quan‐Yang; Clark, Orlo H.

doi:10.1001/archsurg.139.6.656

Cited by 101 publications

(79 citation statements)

References 9 publications

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“…[16][17][18], which are generally regarded as indications for surgical intervention [1,6]. While compressive symptoms associated with retrosternal and malignant thyroid disorders have been shown in many series to be associated with increased perioperative morbidity [12][13][14][15], little data exist on perioperative morbidity in patients with cervical compression due to benign thyroid pathologies.…”

Section: Discussionmentioning

confidence: 99%

Cervical compression due to benign thyroid disorders is not associated with increased postoperative morbidity

Ambe

Lindecke

Knoefel

et al. 2014

Eur Arch Otorhinolaryngol

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Compressive symptoms due to malignant thyroid disorders and retrosternal goiter have been shown to be associated with increased perioperative morbidity. However, little is known about the risk associated with the surgical management of patients presenting with cervical compressive symptoms secondary to benign thyroid disorders. A retrospective review of data of patients undergoing thyroid surgery in a tertiary referral center was performed. The outcomes of patients with compressive symptoms due to benign thyroid disorders were compared to those of patients without compressive symptoms. 886 patients operated upon between 2005 and 2012 were included for analysis. 284 cases with compressive symptoms (study group) were compared to 602 cases without compressive symptoms (control group). There was no difference in the duration of surgery among both groups (123 vs. 126 min, p = 0.75). There was no significant difference among both groups with regard to postoperative hypocalcemia (1.4 vs. 1.1 %), rate of recurrent laryngeal nerve palsy (6.3 vs. 7.2 %) and postoperative bleeding (2.1 vs. 3.1 %). Compressive symptoms resolved in a significant number of patients following surgery. There was no significant difference in postoperative outcome between patients with and without compressive symptoms. Therefore, cervical compression due to benign thyroid disorders is not associated with increased perioperative morbidity.

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Section: Discussionmentioning

confidence: 99%

Cervical compression due to benign thyroid disorders is not associated with increased postoperative morbidity

Ambe

Lindecke

Knoefel

et al. 2014

Eur Arch Otorhinolaryngol

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“…The consequence of mediastinal goiter location is usually tracheal compression and displacement, compression of the esophagus, and distension of the upper chest veins, resulting from an increased pressure in the superior caval vein. The frequently noted distension of the external jugular veins accompanied by the Pemberton's sign is a fairly characteristic indicator of the degree of the superior caval vein compression by the expanding masses of the thyroid tissue [15,16]. An upper GI series with esophageal contrast (A-P and lateral views) allows for determining the degree and site of the goiter compressing the trachea and esophagus.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of mediastinal goiter: risk factors for sternotomy

Cichoń

Anielski

Konturek

et al. 2008

Langenbecks Arch Surg

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Surgical management of patients with mediastinal goiter is the therapeutic modality that requires considerable experience of the surgical team, performed in specialized centers, and appropriate preoperative diagnostic management. Statistically significant risk factors for sternotomy are as follows: recurrent goiter, primary mediastinal goiter, posterior mediastinal location of goiter, and the presence of an aberrant adenoma situated in the mediastinum.

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“…Nerve injury rate in this series (both temporary and definitive) did not differ from the standard reported in literature (13)(14)(15)(16)(17)(18). Is true that we had to cope with small thyroids but surely also the endoscope magnification gave a view of the nerves which, particularly for the superior laryngeal nerve, is far better than in the open operation.…”

Section: Discussionmentioning

confidence: 46%

“…The incidence of this complication is most variable in literature depending from type of disease, type of operation and surgeon experience. The rate of definitive palsy is around 1% but ranges from 0.5 to 14% in literature (13)(14)(15)(16)(17)(18).…”

mentioning

confidence: 99%

New Technologies in Surgery: Diagnosis and Treatment of Complications of Mivat (Minimally Invasive Video-Assisted Thyroidectomy)

Miccoli¹,

Materazzi²,

Berti³

2008

Polish Journal of Surgery

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The aim of the study was to present evolution of the technique of minimally invasive video-assisted thyroidectomy, its advantages, limitations and possible complications related to the method. Material and methods. Minimally invasive video-assisted thyroidectomy (MIVAT) is characterized by a unique central incision of 1.5 cm, 2 cm above the sternal notch. The operative space is maintained by means of an external retraction: no gas insufflation is utilized. Potential complications of Minimally Invasive Video-assisted Thyroidectomy (MIVAT) are roughly the same as in open surgery. Results. Since June 1998 to March 2008 1524 patients underwent a minimally invasive video-assisted thyroidectomy. Complications were represented by transient monolateral recurrent nerve palsy in 38 cases (2.4%), definitive monolateral recurrent nerve palsy in 18 cases (1.1%), bilateral transient recurrent nerve palsy in 2 cases. Fifty five patients exhibited a hypoparathyroidism, which corresponds to 5.1% of the 1059 total thyroidectomies performed, but only 5 complained of a permanent hypocalcemia which necessitated a substitutive therapy, thus reducing the rate of permanent hypoparathyroidism to 0.4%. We registered in two cases of postoperative bleeding requiring re-operation; wound sepsis occurred in three cases. Conclusions. MIVAT unlike other minimally invasive endoscopic techniques proposed for thyroidectomy, reproduces the standard operation and does not introduce any modification of the traditional technique and in our series total complication rate resulted similar to that described in literature for standard thyroidectomy in large series. As long as these criteria are carefully respected one need not to be concerned that these techniques might increase the complication rate.

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Predictors of Airway Complications After Thyroidectomy for Substernal Goiter

Cited by 101 publications

References 9 publications

Cervical compression due to benign thyroid disorders is not associated with increased postoperative morbidity

Cervical compression due to benign thyroid disorders is not associated with increased postoperative morbidity

Surgical management of mediastinal goiter: risk factors for sternotomy

New Technologies in Surgery: Diagnosis and Treatment of Complications of Mivat (Minimally Invasive Video-Assisted Thyroidectomy)

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