Outcome of transcervical thyroidectomy for retrosternal goiter

Abstract EN

Background and objectives The management of retrosternal goiter is a problem which has challenged surgeons.

The development of multinodular retrosternal goiter is still common and knowledge of their treatment is important.

The aim of this study was to analyze a series of patients who underwent surgery for retrosternal goitre, and explore the results of surgical treatment via transcervical approach in term of morbidity and mortality.

Methods A total of 50 patients out of 250 with retrosternal goiter who underwent thyroidectomy by the researcher in Mosul and Duhok from February 1995–December 2009 were included in the study.

Results Out of the total two-hundred fifty patients, fifty (20%) presented with retrosternal extension of goitre.The mean age of the patients with retrosternal extension were 40 years.

Out of the fifty patients, females constituted 80%.

The most common preoperative symptom was shortness of breath (74%).

Twelve percent of patients were asymptomatic.

Preoperative chest radiograph showed tracheal compression in 80% (by lateral view) and tracheal deviation in 20% of patients.

The retrosternal goitre was resected via cervical approach in all patients.

Postoperative complication rate was 20% which includes haematoma in 3 patients, wound infection in 2 patients, early hypoparathyroidisim in 3 patients and temporary recurrent laryngeal nerve injury in 2 patients.

There were no patients with permanent recurrent laryngeal nerve injury, permanent hypoparathyroidisim or tracheomalacia.

All of the patients for whom the surgery was done survived.

Conclusion Resection of thyroid gland through a cervical approach for retrosternal goitres is associated with low rate of morbidity and no mortality.