Özet:

The University of Suleyman Demirel TIP FACULTY JOURNAL: March 2009; 16 (1) Surgeon in Substernal guatres Hasan Turüt*, Mehmet Sırmalı**, Göktürk Fındık***, Suat Gezer***, Gürhan Öz***, Koray Aydoğdu***, Irfan Taştepe***, Sadi Kaya***, Güven Çetin***. Substernal guatr was aimed at clinical and surgical analysis of patients undergoing surgical treatment due to substernal guatr. Tools and Methods: between January 1996 and July 2006 Ataturk Breast Diseases and Breast Surgery Training and Research Hospital Breast Surgery Clinic under substernal guatr diagnosis operations were studied as retrospective. The facts, age, gender, causes of application, findings, surgical approaches, postoperative histopathology and follow-up areas were analyzed. A total of 34 out of 19 females, 15. I was male and the average age was 57.5 (distribution; 25-71) The most common causes of application were proximities related to the respiratory system (depression and cough). 28 (% 82.3) of cases are standard .Collar. While operated with the injection, the remaining 6 cases required additional surgical procedures (party/complete mediansternotomy, toracotomy). The postoperative histopathological examination resulted in the diagnosis of diffuse/nodular colloidal guatra in 29 cases (85.2 percent), while malignity was detected in 2 cases (5.8 percent). The total mortality rate was 17.6%, while postoperative mortality was not observed. The result: in patients with substernal guatra, the surgical approach is an important treatment option. Although the cervical approach is sufficient in most cases, an abnormal thyroid tissue, which indicates intratorasic settlement with partial or complete median sternotomy to be added in the case of indication, can be scratched with low morbidity and mortality. Keywords: Substernal goiter, thyroid, thyroid surgery Abstract Surgical treatment of substernal goiter Objective: Our aim was to analyze the clinical and surgical aspects of the patients with substernal goiter.Materials and Methods: A total of 34 patients who underwent surgical treatment with the diagnosis of substernal goiter at Atatürk Chest Diseases and Chest Surgery Center between January 1996 and July 2005 were evaluated retrospectively. The patients were analyzed with respect to age, gender, presenting symptoms, findings, surgical procedures used, postoperative histopathology and follow-up. Results: Of the 34 patients, 19 were female and 15 were male with an age average of 57.5 years (range; 25-71). The most common symptom was related with the respiratory system (dyspne and cough). A total of 28 patients (82.3%) were managed via standard .Collar. Incision whereas the remaining was required a total of 6 additional surgical procedures (partial/complete median sternotomy, thoracotomy). Of the 34 patients, 29 (85.2%) were diagnosed as diffuse/nodular colloidal goiter postoperatively; malignancy was detected in 2 (5.8%) of the patients. There was no operative mortality and our morbidity rate was 17.6%. The management of choice in patients with substernal goiter is to be surgical. Although cervical incision is adequate in most of the patients, abnormal thyroid tissue can be resected via additional partial or complete mediansternotomy when indicated in patients with intrathoracic localization with low morbidity and mortality rates. Key words: Substernal goiter, thyroid, thyroid surgery

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