A review of surgical management of retrosternal goitre in a single tertiary care referral centre in Sri Lanka

Abstract

Introduction: Retrosternal goitres require surgical removal due to compressive symptoms as well as risk of malignancy. In a majority, the retrosternal part can be removed through the neck incision, while 5-10% requiring a sternotomy. An alternative to sternotomy is thoracoscopy, which is associated with reduced morbidity. Methods: The surgical approach used to resect retrosternal goiters in our unit over a period of two years was evaluated. Results: In fifty four patients out of sixty (90%) with retrosternal extension, resection was feasible from neck. Out of the remaining six, two had median sternotomy while four had thoracoscopy. The operating time, blood loss, post-operative analgesic requirement and hospital stay were less in the thoracoscopy group. Conclusions: Majority of retrosternal goitres can be removed via neck. For those who require access in to chest, thoracoscopy is associated with reduced morbidity and hospital stay, when compared to median sternotomy.