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Fuse Y, Kamada T, Suzuki N, Nishide R, Takahashi J, Nakashima K, Nakaseko Y, Ishigaki T, Yoshida M, Ohdaira H, Suzuki Y. Utility of Novel Clavicle-lifting Technique in Mediastinal Thyroid Surgery: A Case Series Study. In Vivo 2023; 37:2815-2819. [PMID: 37905650 PMCID: PMC10621430 DOI: 10.21873/invivo.13395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Symptomatic mediastinal goitre requires surgery and is usually resectable using the cervical approach alone; however, sternotomy is occasionally required. Sternotomy is a highly invasive procedure, and its complications, including mediastinitis and osteomyelitis, can be critical. To date, there have been no reports of non-invasive techniques to avoid sternotomy for mediastinal thyroid tumours. We investigated the safety and efficacy of thyroidectomy using the clavicle lifting technique with a paediatric Kent hook. PATIENTS AND METHODS This was a retrospective study of 8 patients who underwent thyroidectomy with a clavicle lifting technique between November 2014 and July 2021 at the Department of Surgery, International University of Health and Welfare Hospital. The primary endpoint was sternotomy avoidance rate and R0 resection rate. An extension retractor used in paediatric surgery was used for the clavicle lifting technique. RESULTS Sternotomy avoidance rate and R0 resection rate were 100%. The mean operative time was 161±53.5 min, and the mean blood loss was 125.6±125.8 ml. There were no intraoperative or postoperative complications related to the clavicle lifting technique. CONCLUSION Thyroidectomy with a clavicle lifting technique for mediastinal goitre and thyroid cancer is safe and useful because it avoids sternotomy without causing massive intraoperative bleeding or damage to other organs.
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Affiliation(s)
- Yoshinobu Fuse
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Teppei Kamada
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Norihiko Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Ryo Nishide
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Junji Takahashi
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Keigo Nakashima
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Yuichi Nakaseko
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Takayuki Ishigaki
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Masashi Yoshida
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Hironori Ohdaira
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Yutaka Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
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Oh SL, Chia CLK, Ooi OC, Sonawane V, Rao AD, Singaporewalla R. A rare case of ectopic retrosternal goiter. Clin Case Rep 2021; 9:1849-1852. [PMID: 33936601 PMCID: PMC8077326 DOI: 10.1002/ccr3.3610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/19/2020] [Accepted: 06/07/2020] [Indexed: 11/25/2022] Open
Abstract
It is important for the clinician to be familiar with interpreting a variety of radiological modalities that provide vital information that will aid in the preoperative planning, counseling, and subsequent management of patients with retrosternal goiter.
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Affiliation(s)
- Shen Leong Oh
- Department of General SurgeryKhoo Teck Puat HospitalSingaporeSingapore
| | | | - Oon Cheong Ooi
- Department of Cardiac, Thoracic and Vascular SurgeryNational University Heart HospitalSingaporeSingapore
| | - Vikram Sonawane
- Department of EndocrinologyKhoo Teck Puat HospitalSingaporeSingapore
| | - Anil D. Rao
- Department of General SurgeryKhoo Teck Puat HospitalSingaporeSingapore
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Van Slycke S, Simons AS, Van Den Heede K, Van Crombrugge P, Tournoy K, Simons P, Vermeersch H, Brusselaers N. Combined cervicosternotomy and cervicotomy for true retrosternal goiters: a surgical cohort study. Updates Surg 2021; 73:1-10. [PMID: 33779950 PMCID: PMC8397680 DOI: 10.1007/s13304-021-01027-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022]
Abstract
Objective Intrathoracic goiters are a heterogeneous group characterized by limited or extensive substernal extension. Whereas the former can be treated through cervicotomy, the latter sometimes requires a cervicosternotomy. Whether cervicosternotomy leads to more morbidity remains unclear. This study aimed to compare intra- and postoperative morbidity in patients treated by cervicotomy or cervicosternotomy for intrathoracic goiters and standard thyroidectomy. Methods In a prospectively gathered cohort undergoing thyroid surgery (2010–2019) intra- and postoperative morbidity of cervicotomy (N = 80) and cervicosternotomy (N = 15) for intrathoracic goiters was compared to each other and to a ‘standard’ thyroidectomy (N = 1500). Results An intrathoracic extension prior to surgery was found in 95 (6%) of all thyroidectomies. Eighty patients (84%) were operated by cervicotomy and 15 (16%) by cervicosternotomy. The risk of temporary recurrent laryngeal nerve palsy was much higher in the cervicosternotomy group (21%) compared to cervicotomy (4%) and standard thyroidectomy (3%). The risk of temporary hypocalcemia after cervicotomy (28%) was comparable to a standard thyroidectomy (32%) but higher after cervicosternotomy (20%). No cases of permanent hypocalcemia or laryngeal nerve palsy were observed in both groups with substernal extension. The need for surgical reintervention was significantly higher in the cervicotomy group (6%) compared to cervicosternotomy (0%) and standard thyroidectomy (3%). Conclusion In patients undergoing thyroid surgery for an intrathoracic goiter, cervicosternotomy was associated with more temporary laryngeal nerve palsy, but none of the interventions resulted in higher risks of permanent nerve damage, permanent hypocalcemia, or reintervention for bleeding. Reintervention was even more common after cervicotomy compared to cervicosternotomy. Level of evidence IV Supplementary Information The online version contains supplementary material available at 10.1007/s13304-021-01027-1.
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Affiliation(s)
- S Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.,Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Department of General Surgery, AZ Damiaan, Gouwelozestraat 100, 8400, Ostend, Belgium
| | - A-S Simons
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.,Group of Biomedical Sciences, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - K Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - P Van Crombrugge
- Department of Endocrinology, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - K Tournoy
- Department of Pneumology, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.,Department of Internal Medicine and Paediatrics, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - P Simons
- Department of Radiology, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - H Vermeersch
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Plastic and Reconstructive Surgery, Department of Human Structure and Repair, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - N Brusselaers
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research, Karolinska Institutet, Karolinska Hospital, Tomtebodavagen 16, 17165, Stockholm, Sweden. .,Global Health Institute, Antwerp University, Campus Drie Eiken, Gouverneur Kinsbergencentrum, Doornstraat 331, 2610, Wilrijk, Belgium.
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