縦隔甲状腺腫例に対する手術アプローチ

抄録

A clinical study was conducted of 19 patients who had undergone surgical treatment for mediastinal goiter at our department between 2010 and 2016. Thirteen out of the 19 retrosternal goiters were anterior mediastinal, and 6 were posterior mediastinal. In 17 patients with the substernal goiter, the cervical approach was used, while in the remaining two patients, a thoracic approach was required for goiter removal. In regard to the results of histological examination, all the patients were diagnosed as having adenomatous goiter, and only two patients showed evidence of micropapillary adenocarcinoma. The post-operative course was uneventful, with no major morbidities. Permanent recurrent laryngeal nerve injury occurred in two patients, and hypoparathyroidism in 4 patients. The surgery via the cervical approach for substernal goiter removal was safety performed in almost all the patients, without necessity for any extracervical procedure. The thoracic approach may be needed for the goiter removal in some cases of primary goiter.