P Del Rio1, L Bezer, M F Arcuri, M Sianesi. 1. Unit of General Surgery and Organ Transplantation, Department of Surgical Science, School of Medicine, University of Parma, Via Gramsci 14, 43100, Parma, Italy. paolo.delrio@unipr.it
Abstract
BACKGROUND: The thyroid disease can appear in 0.16-3.3% of cases as mediastinal goiter. The treatment is difficult and requires a mediastinal approach. MATERIALS AND METHODS: We have analyzed our experience from September 1995 to September 2007 among 2,439 thyroidectomies conducted for thyroid disease; 16 cases required a sternotomy, in seven patients conducted as hemiclamshell approach (median sternotomy associated to a fourth intercostals space incision). Preoperative evaluation included otorhinolaryngology evaluation and computed tomography. All the cases were followed up to 12 months. RESULTS: For seven cases treated trough hemiclamshell, the mean age was 57.8 years; hospital stay is 5.2 days. All the patients were discharged after respiratory evaluation; two patients required a pneumological admittance to physio-kinesi-respiratory. There were no cases of hemorrhage, nerve injury, permanent hypocalcemia, and chylothorax. There was no mortality at 30 days. CONCLUSIONS: The hemiclamshell is a safe procedure to treat mediastinal goiter and permit a good exposure of subclavian vessels and mediastinal nodes.
BACKGROUND: The thyroid disease can appear in 0.16-3.3% of cases as mediastinal goiter. The treatment is difficult and requires a mediastinal approach. MATERIALS AND METHODS: We have analyzed our experience from September 1995 to September 2007 among 2,439 thyroidectomies conducted for thyroid disease; 16 cases required a sternotomy, in seven patients conducted as hemiclamshell approach (median sternotomy associated to a fourth intercostals space incision). Preoperative evaluation included otorhinolaryngology evaluation and computed tomography. All the cases were followed up to 12 months. RESULTS: For seven cases treated trough hemiclamshell, the mean age was 57.8 years; hospital stay is 5.2 days. All the patients were discharged after respiratory evaluation; two patients required a pneumological admittance to physio-kinesi-respiratory. There were no cases of hemorrhage, nerve injury, permanent hypocalcemia, and chylothorax. There was no mortality at 30 days. CONCLUSIONS: The hemiclamshell is a safe procedure to treat mediastinal goiter and permit a good exposure of subclavian vessels and mediastinal nodes.
Authors: Bhavin C Shah; C S Ravichand; Srinivas Juluri; Atin Agarwal; C S Pramesh; R C Mistry Journal: Ann Thorac Cardiovasc Surg Date: 2007-04 Impact factor: 1.520
Authors: M de Perrot; E Fadel; O Mercier; P Farhamand; D Fabre; S Mussot; P Dartevelle Journal: Thorac Cardiovasc Surg Date: 2007-02 Impact factor: 1.827