Surgical Pathways And Method Of Operation Of Substernal Goiter

Objective:Discussion substernal goiter surgical treatment and surgical pathways and method.Method:A retrospective study on 48 cases with substernal goiter was made in our hospital.Result:48 cases had been succescflly removed. I type 36 cases,II type 12 cases. A cervical incision alone was performed in 43 cases(89.58%), and sternal splitting incision in 4 cases(8.33%),thoracotomy in 1 cases(2.08%). Reveals three methods of the thyroid gland:traversing the musculature anterior region of neck in 24 cases(55.81%); from linea alba cervicalis center vertical line of separation in 7 cases(16.28%);two-sided pulls open separately the musculature anterior region of neck in 12 cases(27.91%). Pathology report among them there were 22 goiters(45.83%),8 cystic degeneration (16.67%),6 follicular epithelial cell papillary hyperplasia(12.50%),9 adenomas(12.50%),4 adenomatoid proliferative(8.33%),2 papillary carcinoma (12.50%).Complication:hoarse voice 1 cases(2.08%); transitory hoarse voice 2 cases(4.17%); transitory hypoparathyroidism 1 cases(2.08%). Complication rate of cervical incision alone was performed and sternal splitting incision:6.95%and 25%, (P) 0.05).Complication rate of reveals three methods of the thyroid gland(traversing the musculature anterior region of neck;from linea alba cervicalis center vertical line of separation;two-sided pulls open separately the before the neck musculature):4.17%,14.28%,8.33%, (P) 0.05).Conclusion:Most substernal goiter can be removed successfully through a transcervical approach. Reveals thethyroid gland can be used two-sided pulls open separately the musculature anterior region of neck. This way has the wound slightly and the coincidnece time quickly merit, simultaneously has the cosmetology effect, suitable achievement priority selection pathways and method.