Intrathoracic Thyroid Goiters

• Authors: Sławomir Jabłoński , Marcin Wawrzycki , Marian Brocki , Małgorzata Filgus , Jacek Kordiak
• Languages of publication: EN

Abstracts

EN

In this article, the difficulties in treatment of 18 patients with intrathoracic thyroid goiters were discussed.The aim of the study were: defining the etiology and symptomology of goiters within the chest in the own material, conducting the analysis of the diagnostic efficiency, the evaluation of the early results of surgery and postoperative complications.Material and methods. The research material included 18 patients with intarhoracic thyroid goiters after surgical treatment (mediastinal goiters, ectopic goiters). The cases of retrosternal goiters were not analyzed. There was carried out the retrospective analysis of the medical documentation of goiters etiology, the frequency of dominating clinical symptoms, value of diagnostic methods, early effects of surgical treatment and postoperative complications.Results. In the years 2004-2008, operations were performed on 14 women and 4 men with intrathoracic goiters, aged from 34 to 82. The average age of patients was 51.1. The etiology of intrathoracic thyroid goiters were as follows: thyroid goiters (struma nodosa) - 55%, adenoma and thyroid goiters - 17%, thyroid cancer (ca papillare) and thyroid goiters - 11%, ectopic thyroid gland - 11%, thyroid goiters and thyroid inflammation - 6%. The majority of the material were cases of a cervico-mediastinal thyroid gland, only 2 patients were diagnosed with an ectopic thyroid gland located in the mediastinum with no connection with the cervical thyroid. The local symptoms of compression on intrathoracic organs were mostly observed in the clinical picture, 22% of patients were asymptomatic. The diagnostic process included the estimation of the hormonal state and the radiology localised methods among which helical computer tomography was the most valuable. In order to estimate endotracheal intubation conditions 11 patients (61%) underwent brochofiberoscopy. The following accesses were used in the treatment: cervical - 3 cases, partial sternotomy - 11, longitudinal sternotomy - 2, thoracotomy - 1, combined thoracotomy with cervicotomy - 1. Good treatment results were obtained in all cases. The following complications were noted: a permanent paralysis of the laryngeal nerve - 1 case (6%), hypoparathyroidism - 1 (6%).Conclusions. Thyroid goiters situated inside the chest are a rarely met pathology which may cause serious difficulties in surgical treatment. Patients with this illness require a thorough preparation for the treatment including balancing hormonal perturbations, preventing intubation difficulties and access to the necessary quality of a diagnostics wit purpose of planning the most optimal surgical access and avoiding serious perioperative complications.

Keywords

EN

intrathoracic goiter; mediastinal goiter; thyroid surgery

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2010
• Volume: 82
• Issue: 2
• Pages: 69-76

Dates

published

1 - 2 - 2010

online

18 - 3 - 2010

Contributors

author

Sławomir Jabłoński

• Department of Thoracic Surgery, General and Oncologic Surgery, Medical University in Łódź

author

Marcin Wawrzycki

• Department of Thoracic Surgery, General and Oncologic Surgery, Medical University in Łódź

author

Marian Brocki

• Department of Thoracic Surgery, General and Oncologic Surgery, Medical University in Łódź

author

Małgorzata Filgus

• Department of Thoracic Surgery, General and Oncologic Surgery, Medical University in Łódź

author

Jacek Kordiak

• Department of Thoracic Surgery, General and Oncologic Surgery, Medical University in Łódź

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Identifiers

DOI

10.2478/v10035-010-0012-2