Hemiclamshell incision in the treatment of mediastinal goiter

Abstract
Background  The thyroid disease can appear in 0.16–3.3% of cases as mediastinal goiter. The treatment is difficult and requires a mediastinal
approach.

Materials and methods  We have analyzed our experience from September 1995 to September 2007 among 2,439 thyroidectomies conducted for thyroid disease;
16 cases required a sternotomy, in seven patients conducted as hemiclamshell approach (median sternotomy associated to a fourth
intercostals space incision). Preoperative evaluation included otorhinolaryngology evaluation and computed tomography. All
the cases were followed up to 12 months.

Results  For seven cases treated trough hemiclamshell, the mean age was 57.8 years; hospital stay is 5.2 days. All the patients were
discharged after respiratory evaluation; two patients required a pneumological admittance to physio-kinesi-respiratory. There
were no cases of hemorrhage, nerve injury, permanent hypocalcemia, and chylothorax. There was no mortality at 30 days.

Conclusions  The hemiclamshell is a safe procedure to treat mediastinal goiter and permit a good exposure of subclavian vessels and mediastinal
nodes.

Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00423-008-0342-2Authors
P. Del Rio, University of Parma Unit of General Surgery and Organ Transplantation, Department of Surgical Science, School of Medicine Via Gramsci 14 43100 Parma ItalyL. Bezer, University of Parma Unit of General Surgery and Organ Transplantation, Department of Surgical Science, School of Medicine Via Gramsci 14 43100 Parma ItalyM. F. Arcuri, University of Parma Unit of General Surgery and Organ Transplantation, Department of Surgical Science, School of Medicine Via Gramsci 14 43100 Parma ItalyM. Sianesi, University of Parma Unit of General Surgery and Organ Transplantation, Department of Surgical Science, School of Medicine Via Gramsci 14 43100 Parma Italy

Journal Langenbeck's Archives of SurgeryOnline ISSN 1435-2451Print ISSN 1435-2443 (Source: Langenbeck's Archives of Surgery)