[Substernal goitre. Report of 45 cases (author's transl)].
Among 1,000 operated goiters excluding hyperthyroidism, 45 were compressives (4,5%). Epidemiologic factors were elderly patients, ancient unoperated goiters and recidivism of formerly operated goiters. 1. Prognosis is not hopeless since 60% of compressive goiters were benign. On the other hand, the 40% carcinoma growed swiftly, being either anaplastic or follicular but with local or metastatic extension. 2. Clinical aspect is of no use to ascertain benignity or malignity. Extemporaneous histological examination may be falsely reassuring; but the discovery of a carcinoma allows more appropriate operation. 3. In case of acute dyspnea, only tracheal intubation has to be done in emergency. Intubation is always possible. But the operation has to be done later in better technical conditions. Technique and errors to avoid are exposed in details. 4. Complications are scarce. Tracheomalacia never occured. But laryngeal edema or recurential palsy may need a few days intubation. Technical aspects in order to avoid compressive hematoma as well as sequelae are described.
D000368:Aged; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D005260:Female; D006044:Goiter, Nodular / Q000473:pathology; D006045:Goiter, Substernal / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012008:Recurrence; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy
Les goitres compressifs. A propos de 45 cas.