Best approach for posterior mediastinal goiter removal: transcervical incision and lateral thoracotomy.
Surgical removal of intrathoracic goiter can be performed by a cervical approach in the majority of patients. Review of literature shows that experienced surgeons need to perform an extracervical approach in 2-3% of cases. In spite of surgical management of substernal goiter is well defined, there is little available information about surgical approach of intrathoracic goiters extending beyond the aortic arch into the posterior mediastinum. We report two cases and propose combination of cervical incision and muscle-sparing lateral thoracotomy for posterior mediastinal goiter removal. In such cases, we do not favour sternotomy as posterior mediastinum is inaccessible due to the presence of heart and great vessels anterior to the thyroidal mass that would lead to perform a perilous blind dissection. Based in our experience, transcervical and thoracotomy approach is indicated for a complete and safe posterior mediastinal goiter removal.
Departamento de Cirugía General, Unidad de Cirugía Torácica, Hospital Universitari Arnau de Vilanova, Lleida, España. Electronic address: aojanguren.lleida.ics@gencat.cat.
Amaya
A
Ojanguren Arranz
Departamento de Cirugía General, Hospital Universitari Arnau de Vilanova, Lleida, España.
Juan Antonio
JA
Baena Fustegueras
Departamento de Cirugía General, Hospital Universitari Arnau de Vilanova, Lleida, España.
Susana
S
Ros López
Departamento de Cirugía General, Hospital Universitari Arnau de Vilanova, Lleida, España.
Maite
M
Santamaría Gómez
Departamento de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, España.
Iñigo
I
Ojanguren Arranz
Departamento de Cirugía General, Hospital Universitari Arnau de Vilanova, Lleida, España.
Jorge Juan
JJ
Olsina Kissle
D004210:Dissection; D017558:Elective Surgical Procedures; D005260:Female; D006044:Goiter, Nodular / Q000150:complications / Q000601:surgery; D006045:Goiter, Substernal / Q000601:surgery*; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology / Q000601:surgery; D008482:Mediastinum / Q000601:surgery; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D013908:Thoracotomy / Q000379:methods*; D013965:Thyroidectomy / Q000379:methods*
Bocio endotorácico; Esternotomía; Intrathoracic goiter; Mediastino posterior; Posterior mediastinum; Sternotomy; Thoracotomy; Thyroidectomy; Tiroidectomía; Toracotomía