title: Morbidity and mortality of thyroidectomy for substernal goiter.
abstract: BACKGROUND
  Our objective was to evaluate morbidity and mortality of thyroidectomy in substernal goiters and identify patients at risk for these events.
  
  
  METHODS
  The medical records of 127 patients with substernal goiters were retrospectively reviewed.
  
  
  RESULTS
  The most common preoperative symptom was shortness of breath (48%). 13% of the 127 patients were asymptomatic. Preoperative imaging identified tracheal deviation in 69% and tracheal compression in 41% of the cases. Substernal goiters were resected via a cervical approach in 100% of the cases. Six patients (5%) had postoperative hoarseness, 1 had permanent vocal cord paralysis, and 19 (15%) had transient postoperative hypocalcemia. The mortality and permanent hypoparathyroidism were null. Patients with postoperative complications had larger goiters and were more likely to have tracheal compression.
  
  
  CONCLUSIONS
  Thyroid resection via a cervical approach for substernal goiters is associated with low rate of morbidity and no mortality. Patients with large tumors and tracheal compression are more likely to develop postoperative complications.
authors.affiliation: Department of General Surgery, Hotel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. dbabboud@yahoo.fr
authors.forename: Bassam
authors.initials: B
authors.lastname: Abboud
authors.forename: Ghassan
authors.initials: G
authors.lastname: Sleilaty
authors.forename: Nadine
authors.initials: N
authors.lastname: Mallak
authors.forename: Hicham
authors.initials: H
authors.lastname: Abou Zeid
authors.forename: Bassam
authors.initials: B
authors.lastname: Tabchy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery; D006045:Goiter, Substernal / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods