CHALLENGE THYROIDECTOMY MANUAL DELIVERY VERSUS STERNOTOMY IN RETROSTERNAL GOITER | ||
| Journal of the Egyptian Society of Parasitology | ||
| Article 28, Volume 50, Issue 3, December 2020, Pages 698-705 PDF (1.1 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/jesp.2020.131118 | ||
| Authors | ||
| YASSER AHMED EL SAYED1; YASSER MOHAMED SHAFIK2; EISSA ABDEL-HAMED IBRAHIM3 | ||
| 1Consultant of Thoracic Surgery | ||
| 2Consultant Anesthesia and Pain Management | ||
| 3Consultant General Surgery, Military Medical Academy, Cairo, 11291, Egypt | ||
| Abstract | ||
| The study was carried out on 40 patients presented with thyroid swelling admitted at Kobry El-Kobba Military Medical Compass over two years. Eighteen of them suffered from retrosternal goiter and were divided into two groups. GI: 4 males were treated by sternotomy and total thyroidectomy, which histopathological examination showed multinodular goiter. GII: 14 patients (12 males & 2 females) were treated by cervical incision and manual retrosternal goiter deli- very. Patients in both groups were followed up 2 weeks over three months and then one month over a year post-operation for thyroid profile, serum Ca level, and histopathological specimens showed multinodular goiter without malignancy. In GI, one patient developed wound secondary infection and was treated by antibiotic. Another one showed post-operative hypocalcemia and was treated by oral vitamin D and Ca 500 mg and improved after 6 months. In GII, six male patients showed complications; two showed transient hypocalcemia post-operative and were treated by I.V. Ca gluconate 10% every 12hr for 2 days followed by oral Ca every 12hr for another week and then one vitamin D and one Ca- tablet for 6 months. One patient showed neck hematoma and exploration was done to evacuate hematoma and bleeding control. Two patients showed nerve problem in the form of voice change, difficult in swallowing and aspiration. One was managed by endotracheal intubation for 48hr and the second was managed by Oxygen therapy and steroid. One patient showed mild infection and skin edema that was managed by antibiotic and anti-edematous agent. The last one showed sinus formation and was treated by curettage and antibiotic. The hospital stay was long in GI than in GII, as in GI 48hr ventilation used post-operative compared to 24hr in GII, but neither tracheomalacia treatment nor tracheostomy in both groups. | ||
| Keywords | ||
| Retrosternal goiter; Thyroidectomy; Sternotomy; Manual delivery | ||
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