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[胸骨后甲状腺肿的颈外入路]

[Extracervical approach for retrosternal goiter].

作者信息

Pechetov A A, Gulova N V, Volchansky D A, Lednev A N, Baeva A I, Khlan T N, Gruzdev I S

机构信息

Vishnevsky National Medical Research Center for Surgery, Moscow, Russia.

出版信息

Khirurgiia (Mosk). 2025(5):44-50. doi: 10.17116/hirurgia202505144.

Abstract

OBJECTIVE

To analyze treatment outcomes in patients with retrosternal goiter.

MATERIAL AND METHODS

There were 13 patients aged 32-77 years with retrosternal goiter between 2016 and 2024. The ratio of men and women was 2:11.

RESULTS

Twelve patients underwent thyroidectomy, one patient - video-assisted thoracoscopic thymectomy with resection of aberrant goiter. Among 12 patients, thyroidectomy through collotomy was performed in 6 patients, sternotomy was performed in 5 patients. Aberrant goiter was removed through thoracotomy in one patient with recurrent retrosternal goiter. Complicated postoperative period was observed in 4 patients. Two patients underwent postoperative tracheostomy (prevention of respiratory failure following high risk of bilateral paresis of recurrent laryngeal nerves in one case and laryngeal edema in the second case). There were no deaths in long-term period.

CONCLUSION

Preoperative planning should include CT-based analysis of intrathoracic component of thyroid gland and volume of chest cavity. This is valuable to plan the optimal surgical approach and reduces the risk of intraoperative complications.

摘要

目的

分析胸骨后甲状腺肿患者的治疗效果。

材料与方法

2016年至2024年间,有13例年龄在32 - 77岁的胸骨后甲状腺肿患者。男女比例为2:11。

结果

12例患者接受了甲状腺切除术,1例患者接受了电视辅助胸腔镜胸腺切除术并切除了异位甲状腺肿。在12例患者中,6例通过颈部切口进行甲状腺切除术,5例进行胸骨切开术。1例复发性胸骨后甲状腺肿患者通过开胸手术切除异位甲状腺肿。4例患者观察到术后并发症期。2例患者接受了术后气管切开术(1例是为预防双侧喉返神经麻痹高风险后的呼吸衰竭,另1例是为预防喉水肿)。长期无死亡病例。

结论

术前规划应包括基于CT对甲状腺胸内部分及胸腔容积的分析。这对于规划最佳手术方式和降低术中并发症风险具有重要价值。

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