Abstract:
Objective To explore the diagnosis and treatment experience of bipolar coagulation forceps combined with ultrasonic knife transcervical approach for resection of retrosternal goiter.
Methods The medical records of 34 patients with retrosternal goiter admitted from July 2013 to December 2020 were retrospectively reviewed.
Results According to preoperative classification，there were 9 cases of typeⅠ，17 cases of type Ⅱ and 8 cases of type Ⅲ. Among the 34 patients，23 cases had no obvious clinical symptoms，1 case showed fear of heat and hyperhidrosis，and 10 cases showed pressure symptoms such as dysphagia，dyspnea and hoarseness. Postoperative pathology showed that 31 cases were benign，1 case was papillary thyroid carcinoma，1 case was follicular thyroid carcinoma，and 1 case was thyroid schwannoma. The transcervical approach was preferred in all patients，and four of them combined with sternotomy. The incidence of postoperative complications was 8.8%（3/34）. All patients had temporary limb numbness after operation，and their symptoms disappeared after calcium supplementation.
Conclusion After adequate preoperative evaluation and preparation，bipolar electrocoagulation forceps combined with ultrasonic knife is safe and effective in the transcervical approach to remove retrosternal goiter，which can perform "fine anatomy" during the operation，and maximize the protection of parathyroid gland，recurrent laryngeal nerve and other perithyroid tissues and organs.
Key words:
Goiter, substernal,
Cervical approach,
Bipolar electric coagulation forceps,
Ultrasonic knife
Jie Ding, Hong Chen, Qingzhao Feng, Lei Su, Wenxian Guan. Clinical analysis of 34 cases of retrosternal goiter resection via cervical approach with bipolar coagulation forceps combined with ultrasonic knife[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(06): 659-662.