Surgery for retrosternal goiter: cervical approach

Wang, Xu; Zhou, Yuqiu; Li, Chao; Cai, Yongcong; He, Tianqi; Sun, Ronghao; Tian, Wen; Tang, Zhengqi; Sheng, Jianfeng; Liu, Dingrong; Gui, Chunhan; Zeng, Dingfen; Shui, Chunyan; Jang, Jian; Zhu, Guiquan; Ning, Yudong; Wang, Wei

doi:10.21037/gs.2020.03.43

“…Some authors have reported an incidence of sternotomy in 29% of cases, in patients in whom the gland cannot be safely resected through a cervical incision due to the volume of the tumor and the intimate contact with major vessels. 9,14,15 In our study, ITG were removed using a standard cervical approach, in 116 /122 patients (95,08%). Sternotomy was required in 2/122 patients (1,64%) due to a very large posterior mediastinal goiter with contra lateral extension in one patient, and an EITG in the other patient.…”

Section: Resultsmentioning

confidence: 76%

Surgical management of intrathoracic goiters: 20 years experience

Zribi

¹

,

Amina

²

,

Bouassida

³

et al. 2020

Int Surg J

0

View full text Add to dashboard Cite

Background: Surgery is necessary for intrathoracic goiters (ITG) even in asymptomatic forms considering the risks of compression and malignancy. The major problem is the adequate approach. Intrathoracic goiter’s removal can be performed via a cervical approach, whereas sternotomy might be required intraoperatively in some cases.Methods: A retrospective analysis of twenty years on 122 cases of intrathoracic goiters in a referral centre for thoracic surgery was carried out. We included secondary substernal goiters and ectopic thoracic goiters.Our aim was to define the specifities of this surgery and its outcomes. Postoperative data were examined as well as morbidity and mortality factors.Results: The most common symptoms included dyspnea, cough and dysphagia. Whereas Twenty-two patients were asymptomatic. One hundred sixteen patients underwent a successful transcervical incision without thoracic approach. Six cases of primary goiters were noted, of whom 3 were extracted via a cervical approach. Two cases showed unilateral recurrent nerve paralysis and two cases a hypoparathyroidism.Conclusions: Surgical management of intrathoracic goiter was correlated with low morbidity and mortality The cervical approach was performed in the vast majority of cases without an extra cervical procedure. Intrathoracic approaches were restricted to some selected indications.

show abstract

“…Therefore, it is very necessary to accurately evaluate the situation of giant tumor before operation and make individualized operation plan. At present, the preoperative evaluation of goiter is mainly performed by thin-slice CT or MRI two-dimensional sectional anatomical images [11,12]. Therefore, pre-operative reconstruction of the 3D model of the neck by 3D visualization technology, combined with the three-dimensional anatomical relationship between the whole thyroid gland and the nodules, has unique advantages in evaluating the basic situation of giant thyroid nodules, choosing the surgical path and protecting the surrounding normal blood vessels, and helps to form a good surgical treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Application of 3D Visualization Technology in Preoperative Planning of Giant Goiter

Zhang¹

2023

SCSOAJ

0

View full text Add to dashboard Cite

Background and Objectives: 3D visualization technology provides a more intuitive visual virtual reality surgical presentation for preoperative simulation planning, inhand visualization operation and accurate postoperative assessment in surgical procedures, but there is a lack of evidence to support whether this technology is more advantageous in preoperative planning of giant goiter. The aim of this study was to investigate the value of 3D visualization technology in the preoperative planning of giant goiter. Methods:The clinical data of eight patients with giant goiter admitted to the First People's Hospital of Anhui University of Technology for general surgery from October 2020 to August 2022 were retrospectively analyzed. The image data were imported into 3D visualization software (3D Slicer software) in DICOM format for 3D reconstruction to analyze the 3D positional relationship between the giant thyroid nodules and the surrounding tissues and organs, to perform preoperative simulation operations, and to develop precise surgical pathways.Results: All patients were operated according to the optimal plan selected by the simulation operation, and the actual surgical procedure conformed to the preoperative simulation plan 100%, and all of them successfully completed the total resection of giant thyroid nodules without any perioperative death and no new symptoms appeared after the operation. Conclusion:The use of 3D visualization technology in the preoperative planning of giant goiter can accurately obtain 3D anatomical information of the lesion and its adjacent tissues, select the optimal surgical path, and reduce surgical risks, which is of great clinical guidance value in guiding the preoperative precise surgical planning of giant goiter.

show abstract

“…Therefore, it is very necessary to accurately evaluate the situation of giant tumor before operation and make individualized operation plan. At present, the preoperative evaluation of goiter is mainly performed by thin-slice CT or MRI two-dimensional sectional anatomical images [11,12]. Therefore, pre-operative reconstruction of the 3D model of the neck by 3D visualization technology, combined with the three-dimensional anatomical relationship between the whole thyroid gland and the nodules, has unique advantages in evaluating the basic situation of giant thyroid nodules, choosing the surgical path and protecting the surrounding normal blood vessels, and helps to form a good surgical treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2023

SCSOAJ

0

View full text Add to dashboard Cite

Background and Objectives: 3D visualization technology provides a more intuitive visual virtual reality surgical presentation for preoperative simulation planning, inhand visualization operation and accurate postoperative assessment in surgical procedures, but there is a lack of evidence to support whether this technology is more advantageous in preoperative planning of giant goiter. The aim of this study was to investigate the value of 3D visualization technology in the preoperative planning of giant goiter. Methods:The clinical data of eight patients with giant goiter admitted to the First People's Hospital of Anhui University of Technology for general surgery from October 2020 to August 2022 were retrospectively analyzed. The image data were imported into 3D visualization software (3D Slicer software) in DICOM format for 3D reconstruction to analyze the 3D positional relationship between the giant thyroid nodules and the surrounding tissues and organs, to perform preoperative simulation operations, and to develop precise surgical pathways.Results: All patients were operated according to the optimal plan selected by the simulation operation, and the actual surgical procedure conformed to the preoperative simulation plan 100%, and all of them successfully completed the total resection of giant thyroid nodules without any perioperative death and no new symptoms appeared after the operation. Conclusion:The use of 3D visualization technology in the preoperative planning of giant goiter can accurately obtain 3D anatomical information of the lesion and its adjacent tissues, select the optimal surgical path, and reduce surgical risks, which is of great clinical guidance value in guiding the preoperative precise surgical planning of giant goiter.

show abstract

Surgery for retrosternal goiter: cervical approach

Cited by 11 publications

References 29 publications

Surgical management of intrathoracic goiters: 20 years experience

Surgical management of intrathoracic goiters: 20 years experience

Application of 3D Visualization Technology in Preoperative Planning of Giant Goiter

Untitled

Contact Info

Product

Resources

About