Experience of the surgical treatment of ninty-eight cases with substernal goiter

doi:10.3877/cma.j.issn.1674-0793.2014.01.007

Abstract

Abstract:

Objective

To summarize the experience of surgical treatment of substernal goiter.

Methods

The clinical data of 98 patients diagnosed of substernal goiter were retrospectively analyzed.Among them, eighty nine were confirmed to be nodular goiter by pathology, eight were follicular thyroid adenoma and one was papillary thyroid carcinoma. According to SINGH, 37 belonged to Type Ⅰ, 56 TypeⅡ, and 5 Type Ⅲ. Ninty-two patients underwent low neck and collar-type incision, and 6 were given low neck and collar-type incision plus partial sternotomy. Recurrent laryngeal nerve was unveiled generally.

Results

All the operations were successful. The postoperative complications included transient hypocalcemia(4 cases), trachyphonia(3 cases), and hypothyroidism(8 cases).

Conclusions

It is feasible for Type Ⅰ and Ⅱ substernal goiter to be treated with low neck and collar-type incision. The visual identification of recurrent laryngeal nerve is essential to prevent recurrent laryneal nerve damage. Use of harmonic scalpel in substernal goiter surgery can reduce the volume of bleeding and operation time. It is safe and effective in substernal goiter surgery.

Key words: Substernal goiter, Surgical treatment, Harmonic scalpel

Bingxing Zheng, Tianxiong Shi, Jianwei Deng. Experience of the surgical treatment of ninty-eight cases with substernal goiter[J]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(01): 24-27.

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References 9

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手术方式	例数	SINGH分型（例）			手术时间（min）	术中出血量(ml)	术后并发症（例）			术后住院天数（d）
手术方式	例数	Ⅰ	Ⅱ	Ⅲ	手术时间（min）	术中出血量(ml)	甲状腺功能减退	甲状旁腺功能减退	声音嘶哑	术后住院天数（d）
经颈部切口入路（不使用超声刀）	64	26	38	0	86.5±23.8	30.4±10.4	5	2	2	6.4±1.9
经颈部切口入路（不使用超声刀）	?	?	?	?	?	?	5	2	2	6.4±1.9
经颈部切口入路（使用超声刀）	28	11	17	0	68.8±18.8^a	16.2±4.2^a	3	1	0	6.2±1.5
经颈部切口入路（使用超声刀）	?	?	?	?	?	?	3	1	0	6.2±1.5
经颈胸联合切口入路	6	0	1	5	142.3±35.2	45.6±15.8	0	1	1	12.4±3.2
经颈胸联合切口入路	?	?	?	?	?	?	0	1	1	12.4±3.2

手术方式	例数	SINGH分型（例）			手术时间（min）	术中出血量(ml)	术后并发症（例）			术后住院天数（d）
手术方式	例数	Ⅰ	Ⅱ	Ⅲ	手术时间（min）	术中出血量(ml)	甲状腺功能减退	甲状旁腺功能减退	声音嘶哑	术后住院天数（d）
经颈部切口入路（不使用超声刀）	64	26	38	0	86.5±23.8	30.4±10.4	5	2	2	6.4±1.9
经颈部切口入路（不使用超声刀）	?	?	?	?	?	?	5	2	2	6.4±1.9
经颈部切口入路（使用超声刀）	28	11	17	0	68.8±18.8^a	16.2±4.2^a	3	1	0	6.2±1.5
经颈部切口入路（使用超声刀）	?	?	?	?	?	?	3	1	0	6.2±1.5
经颈胸联合切口入路	6	0	1	5	142.3±35.2	45.6±15.8	0	1	1	12.4±3.2
经颈胸联合切口入路	?	?	?	?	?	?	0	1	1	12.4±3.2

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