A critical analysis of 33 patients with substernal goiter surgically treated by neck incision.
The possibility of needing a combined access, with neck and chest incisions makes the treatment of substernal goiter a challenge both in the pre-op and the intraoperative. We hereby, discuss a standardization of the surgical technique to minimize the need for a chest approach, making the substernal goiter a surgically treatable disease, through a single neck incision, and with low indices of complication.


OBJECTIVE
To assess the substernal goiter surgically approach through a neck incision and to analyze the surgical complications.


METHODS
We carried out a historical cohort by retrospective analysis of the charts of patients submitted to thyroidectomy, and 33 of them (10.4%) had substernal goiter.


RESULTS
All 33 patients were surgically treated through a neck incision without the need for sternotomy. We did not observe definitive lesions in the inferior laryngeal nerve or definitive hypoparathyroidism. Only 2 patients had recurrent nerve paresis; and 2 patients were re-operated because of a neck hematoma.


CONCLUSIONS
Patients with substernal goiter can be safely treated surgically through a single neck incision, bearing low complication rates.
Neves
Murilo Catafesta Das
MC
Head and Neck Surgery Program, UNIFESP.
Rosano
Marcello
M
Hojaij
Flávio Carneiro
FC
Abrahão
Márcio
M
Cervantes
Onivaldo
O
Andreoni
Danielle Macellaro
DM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006045:Goiter, Substernal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies