Surgical management of intrathoracic goitres
Por:
Simo, R, Nixon, IJ, Poorten, VV, Quer, M, Shaha, AR, Sanabria, A, Alvarez, FL, Angelos, P, Rinaldo, A, Ferlito, A
Publicada:
1 feb 2019
Resumen:
BackgroundIntrathoracic goitres (ITG) often present with compressive symptoms and require specialised care by experienced surgical teams. Most ITG can be accessed by a transcervical approach (TCA) and only between 1 and 15% will require an extracervical approach (ECA). Many controversies exist regarding the clinical presentation, evaluation, selection of cases for ECA, surgical technique and outcomes. This paper reviews the recent literature onthe management, outcomes and evidence-based treatment strategies of ITG.MethodsWe conducted a review of the literature on the evaluation, management and outcomes of surgery for ITGs.ResultsThe incidence of cancer in the ITGs ranges between 4 and 20%. Multiplanar CT scanning offers the best preoperative evaluation and aids to determine the approach. Most ITG can be accessed by TCA and ECA are only needed in maximum 15% of cases. In experienced hands, the outcome of these surgeries is comparable to thyroid surgery for non-ITG.ConclusionsSurgery for ITG is challenging. The experienced surgeon however, with few exceptions can address ITG via TCA, with outcomes comparable to those of uncomplicated thyroid surgery.
Filiaciones:
Simo, R:
Guys & St Thomas Hosp NHS Fdn Trust, Dept Otorhinolaryngol Head & Neck Surg, St Thomass St, London SE1 9RT, England
Nixon, IJ:
Royal Edinburgh Infirm, Dept Otorhinolaryngol Head & Neck Surg, Edinburgh, Midlothian, Scotland
Poorten, VV:
Univ Hosp Leuven, Dept Otorhinolaryngol Head & Neck Surg, Dept Oncol, Sect Head & Neck Oncol, Leuven, Belgium
Quer, M:
Univ Autonoma Barcelona, Dept Otorhinolaryngol Head & Neck Surg, Hosp San Pau, Barcelona, Spain
Shaha, AR:
Cornell Univ, Coll Med, Dept Head & Neck Surg, Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA
Sanabria, A:
Univ Antiloquia, Dept Surg, Medellin, Colombia
Alvarez, FL:
Univ Asturias, Dept Otorhinolaryngol Head & Neck Surg, Hosp Univ Asturias, Oviedo, Spain
Angelos, P:
Univ Chicago, Med Ctr, Dept Surg, Chicago, IL 60637 USA
Rinaldo, A:
Univ Udine, Otorhinolaryngol Head & Neck Surg, Sch Med, Udine, Italy
Ferlito, A:
Univ Udine, Otorhinolaryngol Head & Neck Surg, Sch Med, Udine, Italy
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