BOCIO CERVICOTORÁCICO ¿De qué depende el abordaje torácico?

Abstract

Background: Only 2% of cervicothoracic goiters are resected through a thoracic approach. There are no strict guidelines that dictate the need for this surgical approach.

Objective: Investigate clinical, radiographic factors associated with the need for a thoracic approach in cervicothoracic goiters.

Design: Retrospective - Observational.

Setting: Public tertiary care head and neck referral center.

Population: 54 patients, 51.8 male with a rate 1/1. mean age was 57.8 years, 29.6% recurred goiters, 81.5% was benign and hte rest malign tumours.

Methods: In 29.6% a thoracic approach was needed: sternotomy in 10, manubriotomy in 4 and lateral thoracotomy in 2. Total thyroidectomy was used i n72.2%.

Results: There were complications in 10 and sequelas in 8. 5 years overall survival in malignant tumors was 25%.

Conclusions: Cervicothoracic seems to be most appropriate term. Patients who needed thoracic approach were adult of both genders. Cervical approach solve most of cases. But 90% of malignant tu- mours needed any type of thoracic approach statiscally significant expressed. Carinal extension, aberrant or posterior goiters, always needed a thoracic approach. Lateral thoracotomy was reserved only for the last two types of goiters.