Experience of the surgical treatment of ninty-eight cases with substernal goiter

Objective To summarize the experience of surgical treatment of substernal goiter. Methods The clinical data of 98 patients diagnosed of substernal goiter were retrospectively analyzed.Among them, eighty nine were confirmed to be nodular goiter by pathology, eight were follicular thyroid adenoma and one was papillary thyroid carcinoma. According to SINGH, 37 belonged to Type Ⅰ, 56 TypeⅡ, and 5 Type Ⅲ. Ninty-two patients underwent low neck and collar-type incision, and 6 were given low neck and collar-type incision plus partial sternotomy. Recurrent laryngeal nerve was unveiled generally. Results All the operations were successful. The postoperative complications included transient hypocalcemia(4 cases), trachyphonia(3 cases), and hypothyroidism(8 cases). Conclusions It is feasible for Type Ⅰ and Ⅱ substernal goiter to be treated with low neck and collar-type incision. The visual identification of recurrent laryngeal nerve is essential to prevent recurrent laryneal nerve damage. Use of harmonic scalpel in substernal goiter surgery can reduce the volume of bleeding and operation time. It is safe and effective in substernal goiter surgery. Key words: Substernal goiter; Surgical treatment; Harmonic scalpel