[Cervico-mediastinal goiter. Our experience].
BACKGROUND
Personal experience about substernal goiter is reported. Stressing laid on the importance of definition: a goiter that is totally or in the most part below the superior thoracic outlet, with normal vascularization.


METHODS



METHODS
retrospective evaluation of patients observed in the last six years.


METHODS
General Surgery I, Policlinico, University of Palermo.


METHODS
four hundred ninety-six thyroidectomies have been performed, 32 patients (6.5%) were found to have substernal goiters. The age was between 42 and 86 years (middle age 59). Male/female = 1/1.9. Asymptomatics were 8 (25%). More frequent symptoms were airway compression (34%), hoarseness (9%), pain (9%), thyrotoxicosis (9%) and dysphagia (3%).


METHODS
total thyroidectomies have been always performed.


METHODS
the incidence, symptoms, short and long term complication have been valued.


RESULTS
There were no postoperative bleeding or lesion of recurrent nerves or definitive hypoparathyroidism. Postoperative hypocalcemia was observed in 9 patients (28%). Only one temporary hypoparathyroidism (two months) was observed. In 2 patients the histologic examination revealed a papillar carcinoma. There were no intraoperative deaths.


CONCLUSIONS
In personal experience the presence of substernal goiter is an indication for total thyroidectomy. The reasons for treating substernal goiter surgically are the following: no effective medical treatment is available; respiratory compromise, thyrotoxicosis, dysphagia, or malignancy can develop in long-standing goiters; surgery, in skilled hands, presents minimal morbidity.
Siragusa
G
G
Cattedra di Chirurgia Generale I, Università degli Studi, Palermo.
Gelarda
E
E
Geraci
G
G
Albanese
L
L
Di Pace
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006045:Goiter, Substernal / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013965:Thyroidectomy
Gozzo cervico-mediastinico. Nostra esperienza.