...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of Cancer Therapy >Surgical Approaches to Retrosternal Goiter, When Sternotomy Is Mandatory? National Cancer Institute Experience (NCI), Cairo University, Egypt
【24h】

Surgical Approaches to Retrosternal Goiter, When Sternotomy Is Mandatory? National Cancer Institute Experience (NCI), Cairo University, Egypt

机译：当必须进行胸骨切开术时，对胸骨后甲状腺肿的手术方法？埃及开罗大学国家癌症研究所经验（NCI）

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Retrosternal goiters (RG) are those lesions extending to occupy the thoracic cavity. They carry a surgical risk due to distorted anatomy, the minimal access, and the potential for great vessels or pleural injury. No other effective therapeutic alternative to surgery exists. Cervicotomy is still the surgical approach of choice, although a form of sternotomy may always be necessary for field extension and safe gland delivery. Materials and Methods: This is a single institution combined retrospective & prospective study including retrospective analysis of all cases presenting to the NCI, Cairo University with RG candidate for surgery between Jan. 2008 until the end of Dec. 2012, and a prospective study of all cases with the same presentation presenting to the NCI between Jan. 2013 until the end of Dec. 2015. Data was collected from archive of patients at the statistical department. Aims: To study the clinico-pathological characteristics, the presentation, work-up, surgical approaches and postoperative complications of RG. Results: 42 patients were included & were divided into benign (34 patients, 80.9%) and malignant groups (8 cases, 19.1%). All patients (100%) were adults ranging (19 to 73 years) with mean 53.1 years. There was a female predominance (36 female, 85.7%) versus (6 males, 14.3%). Median duration of symptomatology was 23 months ranging (6 - 53 months). 23 patients (54.7%) were symptomatic while 19 cases (45.3%) accidently discovered. Mean tumor size was 9.97 cm in the benign group and 11.1 cm in the malignant group. 31 patients (73.8%) were euthyroid, 9 (21.4%) were thyrotoxic and 2 (4.7%) were hypothyroid. All patients (100%) underwent total thyroidectomy. The commonest approach was cervicotomy (33 cases, 78.6%), while a type of sternotomy was done in 9 cases (21.4%). 2 cases (4.7%) received postoperative radiation therapy & 4 cases (9.5%) received postoperative radioactive iodine. No perioperative mortality occurred & the overall morbidity was 6 cases (14.2%) in the benign group and 2 cases (4.7%) in the malignant group (4.7%). The median follow up period was 17.5 months. The median overall survival (OS) was 39.4 months and the median disease free survival (DFS) was 9.8 months for the malignant group. Conclusion: Cervicotomy is a safe favorable approach to remove a RG. Intraoperative field extension up to a form of sternotomy may be necessary for gland delivery with increasing operating time, hospital stay and morbidity. Postoperative morbidity is mainly due to the respiratory, recurrent laryngeal nerve palsy and hypoparathyroidism which is mainly increased when sternotomy is performed.
机译：背景：胸骨后甲状腺肿（RG）是指那些扩大以占据胸腔的病变。由于解剖结构扭曲，通路最少以及可能造成大血管或胸膜损伤，它们具有手术风险。没有其他有效的手术替代疗法。颈动脉切开术仍然是选择的外科手术方法，尽管对于扩大视野和安全地进行腺体切除术，可能始终需要采用胸骨切开术。材料和方法：这是一个单一机构的回顾性和前瞻性研究，包括对从2008年1月至2012年12月结束期间向开罗大学NCI提出的RG候选手术的所有病例的回顾性分析，以及对所有病例的前瞻性研究。在2013年1月至2015年12月之间，向NCI呈现相同表现的病例。数据从统计部门的患者档案中收集。目的：研究RG的临床病理特征，表现，检查，手术方法和术后并发症。结果：纳入42例，分为良性（34例，占80.9％）和恶性组（8例，占19.1％）。所有患者（100％）均为成人（19至73岁），平均53.1岁。女性占多数（36位女性，占85.7％），而男性占6位，占14.3％。症状的中位持续时间为23个月（6-53个月）。有症状的23例（54.7％），而意外发现的19例（45.3％）。良性组的平均肿瘤大小为9.97 cm，恶性组为11.1 cm。甲状腺功能正常的患者31例（73.8％），甲状腺毒性的患者9例（21.4％），甲状腺功能减退的患者2例（4.7％）。所有患者（100％）均行全甲状腺切除术。最常见的方法是宫颈切开术（33例，78.6％），而一种胸骨切开术则进行了9例（21.4％）。术后放射治疗2例（4.7％），术后放射碘4例（9.5％）。没有发生围手术期死亡，良性组的总发病率为6例（14.2％），恶性组为2例（4.7％）。中位随访期为17.5个月。恶性组中位总生存期（OS）为39.4个月，无病生存期（DFS）为9.8个月。结论：颈动脉切开术是去除RG的安全且有利的方法。为了增加手术时间，住院时间和发病率，可能需要进行术中扩大到胸骨切开术的形式，以进行腺体输送。术后发病率主要是由于呼吸，喉返神经麻痹和甲状旁腺功能低下所致，而当进行胸骨切开术时，甲状旁腺功能低下的情况会增加。

著录项

相似文献

  • 外文文献
  • 中文文献
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号