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Sternotomy for substernal goiter: retrospective study of 52 operations

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Abstract

Purpose

Surgical treatment of substernal goiter occasionally involves sternotomy. Classification and handling of these operations are widely discussed. We aimed to review surgical results after thyroid operations including median sternotomy.

Methods

A retrospective review of all thyroid operations performed in the department from 01.01.95 to 31.12.12. In 55 of 2065 thyroid operations (2.7 %), median sternotomy was performed. All hospital journals of the patients were collected and carefully reviewed.

Results

We included 52 of 55 identified patients. Pathologic examinations discovered malignant disease in 4 patients (8 %) and multinodular goiter in 48 patients (92 %). Mean operation time was 4 h and 5 min (n = 48). Mean estimated blood loss was 464 ml (n = 48). Blood transfusion was given in nine operations (17 %). Median duration of postoperative hospitalization was 7 days (range 4–27 days). Pulmonary complications occurred in 11 patients (21 %): six with pneumonia or atelectasis, three with pneumothorax, and two with pleural effusion. Three patients (6 %) had postoperative hypocalcaemia (permanent in two patients (4 %)). Three patients (6 %) had transient voice changes. Permanent vocal cord paresis was not observed in this series of patients.

Conclusion

Thyroid operations with sternotomy are complicated procedures accompanied with considerable pulmonary complications. In spite of a large invasive procedure, the risk of hypoparathyroidism or recurrent laryngeal nerve injury was not increased.

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Authors and Affiliations

  1. Breast and Endocrine Section, Department of Surgery P, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus, Denmark

    Lars Rolighed, Hanne Rønning & Peer Christiansen

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  1. Lars Rolighed
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  2. Hanne Rønning
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  3. Peer Christiansen
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Correspondence to Lars Rolighed.

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Rolighed, L., Rønning, H. & Christiansen, P. Sternotomy for substernal goiter: retrospective study of 52 operations. Langenbecks Arch Surg 400, 301–306 (2015). https://doi.org/10.1007/s00423-015-1288-9

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  • DOI: https://doi.org/10.1007/s00423-015-1288-9

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