Surgical treatment of chest goiter

Introduction. This article describes the clinic and diagnosis of retrosternal goiter and methods of surgical treatment.Materials and methods. The aim of this study was to identify preoperative predictors of sternotomy in the treatment of retrosternal goiter. In the period from 2012 to 2019 in clinic were hospitalised 820 patients. Of these, 48 (5.8%) had a retrosternal goiter and were included in the study. The age of patients varied from 48 to 75 years, the average age was 49.8 years. There were 8 men (16.7%) and 40 women (83.3%). All retrosternal goiter were surgically treated with 44 (91.7%) cervical accesses and 4 (8.3%) sternotomy. The essence of the technique is to ensure maximum mobility of the removed share with the chest component when mobilizing it from top to bottom. The diagnosis was made by chest x-ray, thyroid ultrasound, CT and MRI, as well as thyroid scintography. All patients were given clinical, biochemical analyses and coagulogram.Results. All operations were successful, without serious postoperative complications. Unknown postoperative complications of transient hypocalcemia and transient paralysis of the recurrent laryngeal nerve occurred in 6 (12.5%) and 2 (4.2%). An indication for the average stereotomy was the extension of the goitre below the aortic arch, a large thyroid tissue, extending to the bifurcation of the trachea and ectopic thyroid tissue in the mediastinum.Conclusions. The retrosternal goiter can be removed through a neck incision, but in rare cases a median sternotomy may be required.