Surgical aspects of 175 mediastinal goiters

Vadász, Pál

doi:10.1016/s1010-7940(98)00204-8

Cited by 98 publications

(95 citation statements)

References 18 publications

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“…Besides, in cases of true ectopic goiter, the vascular pedicles to the endothoracic source may be difficult to control through the thoracic outlet [15]. The cervicosternotomy (total longitudinal sternotomy and simple sternal split) is the access route preferred by most authors [4,9,12,16]. This approach allows adequate exposure of the anterior vascular mediastinal structures and facilitates the control of possible bleeding with limited trauma.…”

Section: Discussionmentioning

confidence: 99%

The forgotten goiter: casuistic contribution and considerations for the choice of surgical approach

et al. 2013

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AbstractAim. A residual mediastinal thyroid (“forgotten goiter”) is a well-known, though uncommon, complication of total thyroidectomy. Materials of study. The authors analyze their experience with three cases of goiter forgotten, observed in a series of 2946 thyroid resections in the period 2005–2010. In the study, a preoperative CT of the chest with three-dimensional reconstruction was always performed to examine the topographical relationships of the lesion. Excision was performed through cervicotomy, cervicosternotomic approach and cervicosternotomy, and posterolateral right thoracotomy. Results. There were no complications. Histological examination was suggestive of malignancy in one case (follicular carcinoma with pulmonary metastases). Discussion. The indication for surgery in cases of forgotten goiter is intrinsic to the diagnosis. Preoperative evaluation with accurate topographic imaging is required in all cases in order to understand the nature and location of mediastinal pathological tissue and to identify the most suitable access route. The cervicotomy is the ideal access for low surgical trauma and is easily extendable into a partial or complete sternotomy. A thoracotomy, on the other hand, which is usually reserved for the right side, must be planned preoperatively.

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Section: Discussionmentioning

confidence: 99%

The forgotten goiter: casuistic contribution and considerations for the choice of surgical approach

et al. 2013

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“…A alteração da função tireoidiana não foi achado freqüente. A taxa de hipertireoidismo foi moderada, variando entre 9,0 e 13,1% dos casos de BM (6,19,25,26,32). O hipotireoidismo é manifestação rara no BM (1,3%) (6).…”

Section: Discussionunclassified

“…O hipotireoidismo é manifestação rara no BM (1,3%) (6). A maior parte dos estudos revelou um índice elevado de pacientes assintomáticos, em torno de 60% dos portadores de BM (19,25,26). A detecção de massa mediastinal ao raio X de tórax também foi achado comum como suspeita inicial de BM (10,23), como ocorrido no caso descrito.…”

Section: Discussionunclassified

“…As indicações de cirurgia no BM se restringem a pacientes adultos jovens, em boas condições de saúde e sintomáticos (8,10,19). Outros autores consideram que todos os pacientes uma vez portadores de BM devem ser operados o mais precocemente possível na busca de se evitar complicações agudas secundárias ao BM.…”

Section: Discussionunclassified

“…Complicações estiveram presentes em 26% com paralisia de nervo laríngeo recurrente em 14 pacientes (8%). Concluíram que o tratamento cirúrgico é eficaz, mas deve ser realizado apenas em pacientes com sintomas secundários ao BM (19).…”

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Bócio mergulhante: quando operar?

Maia¹,

Araújo²

2002

Arq Bras Endocrinol Metab

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O bócio mergulhante é uma afecção rara da glândula tireóide, que acomete principalmente mulheres acima de 60 anos, caracterizada por tireóide aumentada de tamanho, peso e volume, que invade a cavidade torácica total ou parcialmente. As condutas clínicas e cirúrgicas no bócio mergulhante ainda são controversas, não havendo um consenso na literatura sobre qual o momento ideal para intervir cirurgicamente nesses pacientes. É preciso conhecer as indicações, conseqüências e complicações do tratamento cirúrgico em determinados tipos de pacientes, como os idosos assintomáticos, avaliando a necessidade real de cirurgia nesses casos. Este trabalho resulta de um relato de caso e uma revisão de publicações sobre tratamento do bócio mergulhante no período de 1995 a 2000. As bases de dados utilizadas foram Medline e Lilacs. Objetiva-se atualizar, orientar e esclarecer dúvidas dos profissionais a respeito desses fatores. Discutem-se os métodos diagnósticos e a conduta terapêutica em casos de bócio mergulhante.

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Predictors of Airway Complications After Thyroidectomy for Substernal Goiter

Shen

Kebebew

Duh³

et al. 2004

Arch Surg

101

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Hypothesis: Airway complications after thyroidectomy for substernal goiter can be predicted by preoperative symptom profiles, radiologic findings, or other factors. Design: Retrospective review. Settings: A university tertiary care center and a veterans' hospital. Patients: Sixty patients with substernal goiter who underwent thyroidectomy between 1993 and 2002. Main Outcome Measures: Symptoms, preoperative radiologic findings, extent of thyroid resection, tumor size, and postoperative complications. Results: Dysphagia was the most common preoperative symptom (n = 26), followed by dyspnea (n=21), orthopnea (n=13), and hoarseness (n=6); 18 patients (30%) had superior vena caval obstruction. Thirteen patients (22%) were asymptomatic. Preoperative imaging identified tracheal deviation or compression in 45 patients

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Surgical aspects of 175 mediastinal goiters

Cited by 98 publications

References 18 publications

The forgotten goiter: casuistic contribution and considerations for the choice of surgical approach

The forgotten goiter: casuistic contribution and considerations for the choice of surgical approach

Bócio mergulhante: quando operar?

Predictors of Airway Complications After Thyroidectomy for Substernal Goiter

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