Massard G, Wihlm J M, Jeung M Y, Roeslin N, Dumont P, Witz J P, Morand G
Service de Chirurgie Thoracique, Hôpital civil, CHRU, Strasbourg.
Ann Chir. 1992;46(8):770-3.
The authors relate their experience with 7 cases of mediastinal goiter residual to a subtotal thyroidectomy for substernal goiter. The differential diagnosis with ordinary recurrence was based on the absence of connection with the cervical remnant. The reasons for surgical decision-making was mediastinal compression in 4 patients, hyperthyroidism in 1 patient and absent diagnosis in 1 patient; surgery was systematic in 1 asymptomatic patient. Sternal splitting incision was required in 6 patients: alone in 3, associated with cervical incision in 3 others; excision by an exclusively cervical route was possible in one patient. No malignancy was discovered. Postoperative outcome was uncomplicated in all patients. The residual goiter has the same clinical and paraclinical presentation as the ordinary intrathoracic goiter; treatment should be principally surgical for the same reasons. Nevertheless, for this mediastinal tumor, sternum-splitting incision will be required in most cases.
作者介绍了7例因胸骨后甲状腺肿行甲状腺次全切除术后纵隔甲状腺肿残留的经验。与普通复发的鉴别诊断基于与颈部残余组织无连接。手术决策的原因是4例患者有纵隔压迫，1例患者有甲状腺功能亢进，1例患者诊断不明；1例无症状患者进行了系统性手术。6例患者需要胸骨劈开切口：3例单独使用，另外3例与颈部切口联合使用；1例患者可通过单纯颈部途径切除。未发现恶性肿瘤。所有患者术后结果均无并发症。残留甲状腺肿与普通胸内甲状腺肿具有相同的临床和辅助检查表现；出于相同原因，治疗应以手术为主。然而，对于这种纵隔肿瘤，大多数情况下需要胸骨劈开切口。
