[Surgical access for thoracic and intrathoracic goiter].

Abstract

Objective: To evaluate the effectiveness of surgical approach for resection of retrosternal and intrathoracic goiter.

Material and methods: There were 33 patients who underwent surgery for retrosternal (31) and intrathoracic goiter (2) through various surgical approaches. For retrosternal goiter, a Farabeuf hook was used to remove a large retrosternal component of tumor.

Results: In 28 cases (84.8%), substernal goiter was resected through cervical collar incision. In 4 cases, a Farabeuf hook was used to extract retrosternal part of the goiter to the neck and avoid sternotomy. In one case, a combined approach was used (thoracoscopy and cervical collar incision). Sternotomy was performed in only one patient for suspected thyroid malignancy. In two patients with tumors of posterior mediastinum, intrathoracic goiter was removed through thoracoscopic access.

Conclusion: Cervical collar incision allows resection of retrosternal goiter in 84.4% of cases. Retrosternal part can be effectively displaced to the neck wound using a Farabeuf hook. Thoracoscopy is preferable for removal of intrathoracic goiter and can be used to mobilize a large node in mediastinum as an alternative to sternotomy.