Wu G, Song M, Chen F, Zeng Z, Wu M, Xu G, Guo Z, Zhang Q, Yang A, Chen W, Li H
Department of Head and Neck Surgery, Sun Yat-Sen University of Medical Sciences, Cancer Centre, Tumor Hospital, Guangzhou 510060, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2001 Oct;36(5):380-2.
To study the surgical approaches and operative techniques for substernal goiter.
A retrospective study of 27 cases with substernal thyroid nodules was made in our hospital.
The operations on 27 patients with substernal nodules have been successfully carried out. Among them, 10 were goiters, 9 adenomas, 4 malignancy and 4 were thyroid cancer metastasizing to paratracheal or substernal nodes. Resection via cervical collar incision was adequate in 23 cases. Three thyroid cancers with paratracheal node metastasis were completely resected by sternotomy and only one thyroid cancer with paratracheal and substernal nodes metastasis was resected by combined thoracotomy and cervical collar incision.
Resection via cervical collar incision for all retrosternal thyroid nodules were advised. The preliminary experience with this procedure suggests that it has some advantages in the management of substernal goiter, including: 1. ease of operation compared to both sternotomy and thoracotomy; 2. relatively low morbidity; 3. safe and reliable.
研究胸骨后甲状腺肿的手术入路及手术技巧。
对我院27例胸骨后甲状腺结节患者进行回顾性研究。
27例胸骨后结节患者手术均获成功。其中，甲状腺肿10例，腺瘤9例，恶性肿瘤4例，甲状腺癌转移至气管旁或胸骨后淋巴结4例。23例经颈部领式切口切除足够。3例伴有气管旁淋巴结转移的甲状腺癌经胸骨正中切开术完全切除，仅1例伴有气管旁及胸骨后淋巴结转移的甲状腺癌经胸壁切开术与颈部领式切口联合切除。
建议对所有胸骨后甲状腺结节均行经颈部领式切口切除。该手术的初步经验表明，其在胸骨后甲状腺肿的治疗中具有一些优势，包括：1. 与胸骨正中切开术和胸壁切开术相比，操作简便；2. 发病率相对较低；3. 安全可靠。
