Recurrent substernal nodular goiter: incidence and management

Surgery
B HsuL Delbridge

Abstract

Surgery for recurrent multinodular goiter is associated with an increased risk of complications. When recurrence occurs in a substernal location, difficulties associated with surgical removal may be even more significant. Information relating to indications for surgery, procedure performed, pathologic findings, and surgical complications was obtained from a prospective thyroid surgery database maintained in our unit for the past 39 years. During the study period 234 patients underwent operation for retrosternal recurrence of a nodular goiter. In the majority of cases (51%) the indication for surgery was the presence of compressive symptoms. In only four cases was a sternal split required to remove substernal recurrence. Complications occurred in 35 patients, including four permanent recurrent laryngeal nerve palsies. No patient had permanent hypoparathyroidism. Surgery for recurrent substernal goiter, although technically demanding, can be performed with a minimum of morbidity if appropriate attention is paid to anatomy and embryology. A sternal split is only rarely required.

References

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Dec 1, 1987·Annals of Surgery·T S ReeveP Crummer
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Citations

Jan 23, 2004·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·A RíosP Parrilla
Sep 8, 2009·Thyroid : Official Journal of the American Thyroid Association·Frederik A VerburgChristoph Reiners
Jan 1, 2009·BMJ Case Reports·Mehmet UludagBulent Citgez
Feb 18, 2003·Acta chirurgica Iugoslavica·M IgnjatovićZ Kostić
Feb 13, 2008·World Journal of Surgery·Matthew L WhitePaul G Gauger
May 25, 2010·Cirugía española·Karol de Aguiar-QuevedoJuan Pastor-Guillén
Feb 19, 2015·Langenbeck's Archives of Surgery·Lars RolighedPeer Christiansen
Jun 13, 2003·Endocrinology and Metabolism Clinics of North America·Reza ZarnegarOrlo H Clark
Jun 22, 2005·The Annals of Otology, Rhinology, and Laryngology·Benjamin W Cilento, Neal Futran
Sep 6, 2003·ANZ Journal of Surgery·Leigh Delbridge
Aug 12, 2020·Journal of Endocrinological Investigation·M Knobel

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