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Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter
Introduction: The treatment of choice for retrosternal goiters (RSG) is surgical resection to relieve symptoms and rule out malignancy. Although the majority of RSG can be removed by a cervical approach only, an extracervical approach (e.g., sternotomy, thoracotomy or thoracoscopy) may be required....
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219883/ https://www.ncbi.nlm.nih.gov/pubmed/34179070 http://dx.doi.org/10.3389/fsurg.2021.695963 |
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author | Nesti, Cédric Wohlfarth, Benny Borbély, Yves M. Kaderli, Reto M. |
author_facet | Nesti, Cédric Wohlfarth, Benny Borbély, Yves M. Kaderli, Reto M. |
author_sort | Nesti, Cédric |
collection | PubMed |
description | Introduction: The treatment of choice for retrosternal goiters (RSG) is surgical resection to relieve symptoms and rule out malignancy. Although the majority of RSG can be removed by a cervical approach only, an extracervical approach (e.g., sternotomy, thoracotomy or thoracoscopy) may be required. Herein, we describe a refined thoracoscopic-assisted cervical two-team RSG resection without thoracoscopic mediastinal dissection. Technique: A 57-year-old man presented with a large RSG with posterior mediastinal extension (PME) and extensive peritumoral vascularization. Due to its extension below the aortic arch and its small connection with the right thyroid lobe, a combined cervical and thoracoscopic approach was intended. The endocrine surgery unit performed the cervical mobilization of the right thyroid lobe, while the thoracic surgery unit gently pushed the mediastinal tumor through the thoracic inlet without performing mediastinal dissection. This allowed a safe visualization of the inserting vessels by the endocrine surgery team at the neck, followed by a stepwise division of the vessels and resection of the retrosternal nodule through the cervical access. Comment: The described approach is indicated for RSG with posterior mediastinal extension, anteroposterior dimension smaller than the thoracic inlet and inaccessibility from a cervical approach only. This minimally invasive approach is associated with a faster recovery, decreased morbidity and postoperative pain, shorter hospital stay and better cosmetic results. |
format | Online Article Text |
id | pubmed-8219883 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82198832021-06-24 Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter Nesti, Cédric Wohlfarth, Benny Borbély, Yves M. Kaderli, Reto M. Front Surg Surgery Introduction: The treatment of choice for retrosternal goiters (RSG) is surgical resection to relieve symptoms and rule out malignancy. Although the majority of RSG can be removed by a cervical approach only, an extracervical approach (e.g., sternotomy, thoracotomy or thoracoscopy) may be required. Herein, we describe a refined thoracoscopic-assisted cervical two-team RSG resection without thoracoscopic mediastinal dissection. Technique: A 57-year-old man presented with a large RSG with posterior mediastinal extension (PME) and extensive peritumoral vascularization. Due to its extension below the aortic arch and its small connection with the right thyroid lobe, a combined cervical and thoracoscopic approach was intended. The endocrine surgery unit performed the cervical mobilization of the right thyroid lobe, while the thoracic surgery unit gently pushed the mediastinal tumor through the thoracic inlet without performing mediastinal dissection. This allowed a safe visualization of the inserting vessels by the endocrine surgery team at the neck, followed by a stepwise division of the vessels and resection of the retrosternal nodule through the cervical access. Comment: The described approach is indicated for RSG with posterior mediastinal extension, anteroposterior dimension smaller than the thoracic inlet and inaccessibility from a cervical approach only. This minimally invasive approach is associated with a faster recovery, decreased morbidity and postoperative pain, shorter hospital stay and better cosmetic results. Frontiers Media S.A. 2021-06-09 /pmc/articles/PMC8219883/ /pubmed/34179070 http://dx.doi.org/10.3389/fsurg.2021.695963 Text en Copyright © 2021 Nesti, Wohlfarth, Borbély and Kaderli. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Nesti, Cédric Wohlfarth, Benny Borbély, Yves M. Kaderli, Reto M. Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter |
title | Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter |
title_full | Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter |
title_fullStr | Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter |
title_full_unstemmed | Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter |
title_short | Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter |
title_sort | case report: modified thoracoscopic-assisted cervical resection for retrosternal goiter |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219883/ https://www.ncbi.nlm.nih.gov/pubmed/34179070 http://dx.doi.org/10.3389/fsurg.2021.695963 |
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