Simultaneous unilateral anterior thoracoscopy with transcervical thyroidectomy for the resection of large mediastinal thyroid goiter

Brichkov, Igor; Chiba, Shintaro; Lagmay, Victor M.; Shaw, Jason A.; Harris, Loren J.; Weiss, Michael

doi:10.21037/jtd.2017.07.89

Cited by 5 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While thoracotomy and thoracoscopy both allow an excellent exposure of the posterior mediastinum, the minimally invasive approach is associated with a faster recovery, decreased morbidity and postoperative pain, shorter hospital stay and better cosmetic results ( 5 , 8 ). Thoracoscopy, and more recently robotic assisted thoracoscopy, have been used with increasing frequency to approach RSG and are described in a few case series ( 4 – 6 , 9 , 10 ).…”

Section: Commentmentioning

confidence: 99%

Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter

et al. 2021

View full text Add to dashboard Cite

Introduction: The treatment of choice for retrosternal goiters (RSG) is surgical resection to relieve symptoms and rule out malignancy. Although the majority of RSG can be removed by a cervical approach only, an extracervical approach (e.g., sternotomy, thoracotomy or thoracoscopy) may be required. Herein, we describe a refined thoracoscopic-assisted cervical two-team RSG resection without thoracoscopic mediastinal dissection.Technique: A 57-year-old man presented with a large RSG with posterior mediastinal extension (PME) and extensive peritumoral vascularization. Due to its extension below the aortic arch and its small connection with the right thyroid lobe, a combined cervical and thoracoscopic approach was intended. The endocrine surgery unit performed the cervical mobilization of the right thyroid lobe, while the thoracic surgery unit gently pushed the mediastinal tumor through the thoracic inlet without performing mediastinal dissection. This allowed a safe visualization of the inserting vessels by the endocrine surgery team at the neck, followed by a stepwise division of the vessels and resection of the retrosternal nodule through the cervical access.Comment: The described approach is indicated for RSG with posterior mediastinal extension, anteroposterior dimension smaller than the thoracic inlet and inaccessibility from a cervical approach only. This minimally invasive approach is associated with a faster recovery, decreased morbidity and postoperative pain, shorter hospital stay and better cosmetic results.

show abstract

Section: Commentmentioning

confidence: 99%

Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Currently, surgeons have developed various techniques for endoscopic thyroid surgery techniques, including the transoral vestibular (3-5), trans-axillary (6), anterior breast (7), and transcervical approaches (8), as well as hybrid approaches such as the axillary bilateral breast approach (9), bilateral axillary-breast approach (10), and unilateral trans-axillary-trans-mammary approach (11). Each approach has its distinct characteristics, advantages, and drawbacks.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic thyroidectomy via areola approach for stage T1 papillary thyroid carcinoma: feasibility, safety, and oncologic outcomes

Huo,

Xu,

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

PurposeTo evaluate the feasibility, safety, and oncologic outcomes associated with endoscopic thyroidectomy via the areolar approach (ETAA), compared with conventional open thyroidectomy (COT) for the treatment of stage T1 papillary thyroid carcinoma (PTC).MethodsBetween January 2021 and June 2022, a total of 1204 patients diagnosed with PTC underwent screening, out of which 138 patients were selected for inclusion in the study population after propensity score matching (92 patients in the ETAA group and 46 patients in the COT group). The study included the collection and analysis of clinicopathologic characteristics, intraoperative outcomes, postoperative outcomes, complications, and follow-up data using R software.ResultsThe operative time for the ETAA group was longer than that for the COT group (160.42 ± 32.21 min vs. 121.93 ± 29.78 min, p < 0.0001). However, there were no significant differences between the two groups in terms of intraoperative blood loss, the extent of surgical resection, the number of dissected lymph nodes, the number of metastatic lymph nodes, and the rate of parathyroid autotransplantation. Postoperative drainage and C-reactive protein levels were higher in the ETAA group than in the COT group, but there were no significant differences in 24-hour visual analogue scale scores, white blood cell counts, drainage duration, or postoperative hospital stay. Complication rates were similar between the two groups, and no permanent recurrent laryngeal nerve palsy or hypoparathyroidism was observed. Patients who underwent ETAA reported greater cosmetic satisfaction and quality of life than those who underwent COT. During the follow-up phase, only one patient in the COT group developed lateral cervical lymph node involvement requiring reoperation.ConclusionETAA is a safe and feasible surgical method for patients with stage T1 PTC, providing results similar to COT in terms of oncologic completeness, while avoiding neck scars, with excellent cosmetic effects.Clinical trial registrationChinese Clinical Trial Registry center, identifier ChiCTR2300077109

show abstract

Resection of mediastinal goiter extending to the carina with use of artificial pneumothorax, two-lung ventilation, and thoracoscopy, with the patient in a prone position

Hayashi

Kawada

Hyakushima

et al. 2018

Gen Thorac Cardiovasc Surg

View full text Add to dashboard Cite

A 67-year-old woman was presented with a mediastinal tumor extending from the left lobe of the thyroid and passing through the posterior trachea, causing displacement of the esophagus to the left side of the patient and then descending into the right side of the mediastinum to below the carina. Surgery was performed under two-lung ventilation with the patient in a prone position; general anesthesia was performed with a single-lumen tube combined with artificial pneumothorax. In thoracoscopic surgery, we were able to confirm and preserve anatomical structures. After detachment of the tumor at the level of the left and right subclavian arteries, the patient was placed supine, a cervical incision was added, and the tumor was extracted. The tumor was diagnosed as a nonmalignant mediastinal goiter (MG). No such surgical report was found in the literature, and one would be useful for this new approach to MG removal.

show abstract

Simultaneous unilateral anterior thoracoscopy with transcervical thyroidectomy for the resection of large mediastinal thyroid goiter

Cited by 5 publications

References 13 publications

Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter

Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter

Endoscopic thyroidectomy via areola approach for stage T1 papillary thyroid carcinoma: feasibility, safety, and oncologic outcomes

Resection of mediastinal goiter extending to the carina with use of artificial pneumothorax, two-lung ventilation, and thoracoscopy, with the patient in a prone position

Contact Info

Product

Resources

About