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Predictors of the need for an extracervical approach to intrathoracic goitre
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Predictors of the need for an extracervical approach to intrathoracic goitre
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Journal Article
Predictors of the need for an extracervical approach to intrathoracic goitre
2019
Overview
Background Sternotomy and lateral thoracotomy are required infrequently to remove an intrathoracic goitre (ITG). As few studies have explored the need for an extracervical approach (ECA), the aim of this study was to examine this in a large cohort of patients. Methods A prospective database of all patients who had surgery for ITG between 2004 and 2016 was interrogated. Patient demographics, preoperative characteristics and type of operation were analysed to identify factors associated with an ECA. Results Of 237 patients who had surgery for ITG, 29 (12·2 per cent) required an ECA. ITGs below the aortic arch (odds ratio (OR) 10·84; P = 0·004), those with an iceberg shape (OR 59·30; P < 0·001) and revisional surgery (OR 4·83; P = 0·022) were significant preoperative predictors of an ECA. Conclusion The extent of intrathoracic extension in relation to the aortic arch, iceberg goitre shape and revisional surgery were independent risk factors for ECA. Careful preoperative assessment should take these factors into consideration when determining the optimal surgical approach to ITG. The aim of this study was to explore the need for an extracervical approach (ECA) to remove an intrathoracic goitre (ITG) analysing a large prospective cohort of patients. The extent of intrathoracic extension in relation to the aortic arch, iceberg goitre shape and revision surgery were independent risk factors for ECA. Careful preoperative assessment taking these factors into consideration is recommended for optimal surgical management of ITGs. Useful factors to determine approach
Publisher
John Wiley & Sons, Ltd,Oxford University Press
Subject
/ Aorta, Thoracic - diagnostic imaging
/ Endoscopic Ultrasound-Guided Fine Needle Aspiration
/ Female
/ Goiter, Substernal - diagnosis
/ Goiter, Substernal - surgery
/ Humans
/ Male
/ Original
/ Ostomy
/ Patients
/ Sternotomy - statistics & numerical data
/ Studies
/ Surgery
/ Thoracotomy - statistics & numerical data
