We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
THYROIDECTOMY IS SAFE AND EFFECTIVE FOR RETROSTERNAL GOITRE.
- Authors
Chauhan, Ajay; Serpell, Jonathan W.
- Abstract
Background: Retrosternal goitre was defined as any thyroid enlargement identified below the thoracic inlet at operation, with the patient’s neck held in extension. The aim of this study was to determine the characteristics of the patients, the goitres, the surgery and its morbidity (including tracheomalacia, recurrent laryngeal nerve palsy and hypocalcaemia) and the incidence of malignancy in order to establish guidelines for managing patients with a retrosternal goitre. Methods: Data were collected prospectively on all thyroidectomies carried out by a single surgeon over 14 years. Patients underwent appropriate preoperative assessment and thyroidectomy was carried out using a standardized capsular dissection technique. There were 199 cases of retrosternal extension. Results: Retrosternal extension was significantly more common on the left side than on the right side (ratio 3:2, P < 0.05). Most patients (83.4%) had significant symptoms that were relieved by surgery. Of the 199 thyroidectomies, none required a sternal split. The rate of malignancy was low (2.5%). Postoperative morbidity was 30%, the majority being asymptomatic temporary hypocalcaemia. There were no patients with permanent recurrent laryngeal nerve palsies or permanent hypoparathyroidism. There was one case of tracheomalacia. There was no death. Conclusion: Retrosternal goitre is a frequently symptomatic condition, with a low but definite rate of malignancy. Surgery is usually possible through a cervical incision and with an acceptable risk of significant morbidity. Thyroidectomy should be recommended as the treatment of choice.
- Subjects
THYROIDECTOMY; GOITER; ENDOCRINE diseases; THYROID diseases; HYPERTHYROIDISM; DISEASES
- Publication
ANZ Journal of Surgery, 2006, Vol 76, Issue 4, p238
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/j.1445-2197.2006.03699.x