title: [Cervico-mediastinal goiter. Our experience].
abstract: 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.
authors.affiliation: Cattedra di Chirurgia Generale I, Università degli Studi, Palermo.
authors.forename: G
authors.initials: G
authors.lastname: Siragusa
authors.forename: E
authors.initials: E
authors.lastname: Gelarda
authors.forename: G
authors.initials: G
authors.lastname: Geraci
authors.forename: L
authors.initials: L
authors.lastname: Albanese
authors.forename: G
authors.initials: G
authors.lastname: Di Pace
mesh_terms: 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
vernacular_title: Gozzo cervico-mediastinico. Nostra esperienza.