Med Bull Sisli Etfal Hosp. 2022; 56(4): 439-452 | DOI: 10.14744/SEMB.2022.41103

Surgical Treatment of Substernal Goiter Part 2: Cervical and Extracervical Approaches, Complications

Mehmet Uludag¹, Mehmet Taner Unlu¹, Nurcihan Aygun¹, Adnan Isgor^2
1Division of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
²Deparment of General Surgery, Sisli Memorial Hospital, Istanbul, Türkiye

The most appropriate treatment of substernal goiter (SG) is surgery. These patients should be evaluated carefully and multidisciplinary in pre-operative period and surgical management should be planned preoperatively. Although most of the SGs can be resected by the cervical approach, an extracervical approach may be required in a small proportion of patients. Surgical complications of SG related to thyroidectomy are higher than other thyroidectomies. In addition to the complications related to thyroidectomy, complications related to the type of surgical intervention may also occur in SG. The patients who may be needed extracervical approaches should be consulted with thorax surgeons, cardiovascular surgeons, and anesthesiologists preoperatively; the surgical management should be planned together. In this part, we aimed to evaluate the cervical approach methods, extracervical approach methods, technical details, and complications in detail.

Keywords: Extracervical approaches, Sternotomy, Substernal goiter, Thoracotomy

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Substernal guatrýn cerrahi tedavisi part 2: Servikal ve ekstra servikal yaklaþýmlar, komplikasyonlar

Mehmet Uludag¹, Mehmet Taner Unlu¹, Nurcihan Aygun¹, Adnan Isgor^2
1Türkiye Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Anabilim Dalý, Ýstanbul
²Þiþli Memorial Hastanesi, Genel Cerrahi Kliniði, Ýstanbul

Substernal guatrýn en uygun tedavisi cerrahidir. Bu hastalar preoperatif dönemde dikkatli ve multidisipliner olarak deðerlendirilmeli ve cerrahi tedavi preoperatif olarak planlanmalýdýr. Substernal guatrlarýn çoðu servikal yaklaþýmla rezeke edilebilmesine raðmen, hastalarýn küçük bir kýsmýnda ekstraservikal yaklaþým gerekebilir. Tiroidektomiye baðlý substernal guatrýn cerrahi komplikasyonlarý diðer tiroidektomilere göre daha yüksektir. Substernal guatrda tiroidektomiye baðlý komplikasyonlarýn yaný sýra cerrahi giriþimin tipine baðlý komplikasyonlar da ortaya çýkabilir. Ekstra servikal yaklaþým gerekebilecek hastalar ameliyat öncesi göðüs cerrahisi, kalp damar cerrahisi ve anestezi uzmaný ile konsülte edilmeli; cerrahi tedavi birlikte planlanmalýdýr. Bu bölümde servikal yaklaþým yöntemlerini, ekstra servikal yaklaþým yöntemlerini, teknik detaylarý ve komplikasyonlarý detaylý olarak deðerlendirmeyi amaçladýk. (SETB-2022-10-217)

Anahtar Kelimeler: Substernal Guatr, Ekstraservikal Yaklaþýmlar, Sternotomi, Torakotomi

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