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

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.