D'Alia Claudio, Tonante Agata, Lo Schiavo Maria Grazia, Taranto Filippo, Bonanno Loretta, Gagliano Ettore, Di Giuseppe Giovanna, Pagano Duilio, Sturniolo Giovanni
Dipartimento di Discipline Chirurgiche Generali e Speciali, U.O. di Chirurgia Generale VI, Università di Studi di Messina.
Chir Ital. 2002 Jul-Aug;54(4):576-80.
There are cases in which resection of cervico-mediastinal goitres requires additional thoracic access as an adjunct to standard transverse cervicotomy, and typically this takes the form of sternotomy or thoracotomy. The authors propose transclavicular access as an alternative to thoracotomy or sternotomy access for the removal of such goitres. This technical variant is performed by means of resection of the middle third of the clavicle and extraperiosteal disarticulation. They report a case of cervicomediastinal or "plunged" goitre associated with mediastinal metastasis from a follicular thyroid carcinoma in a 77-year-old woman, in whom this technical variant was used. They conclude by stressing the greater effectiveness, ease of execution and relatively limited "aggressiveness" of the technique in comparison with other ways of reaching the mediastinum. The variant proves effective in solving a number of technical, functional and aesthetic problems.
在某些情况下，切除颈纵隔甲状腺肿需要额外的胸部入路作为标准横向颈部切开术的辅助手段，通常采用胸骨切开术或开胸术的形式。作者提出经锁骨入路作为开胸术或胸骨切开术入路切除此类甲状腺肿的替代方法。这种技术变体通过切除锁骨中三分之一和骨膜外关节离断来进行。他们报告了一例77岁女性的颈纵隔或“坠入性”甲状腺肿，伴有滤泡状甲状腺癌的纵隔转移，该病例采用了这种技术变体。他们强调，与其他进入纵隔的方法相比，该技术具有更高的有效性、易于实施且“侵袭性”相对有限，从而得出结论。该变体在解决一些技术、功能和美学问题方面证明是有效的。
