Surgical Management of Retrosternal Goitre - A Single Surgeon Experience in 30 Years

Background: The definition of retrosternal goitre is unclear and not uniform among the authours. As most of the authours defined retrosternal goitre as the goitre with its greater mass is inferior to thoracic inlet. Haller described the first retro-sternal goitre in 1749. Reported incidence of the retrosternal goitres is 1 % to 20 %. There are no clear guidelines for pre-operatively identifying those patients that may require an intrathoracic approach. Material and methods: During a period of 30 years from 1986 to 2016 nearly 36 cases of retro-sternal goitres were encountered in various institutions by a single surgeon. Results: Retrosternal goitres were resected after a median sternotomy in all the 36 cases. There were 2 minor complications and no mortality. There was a clear and highly significant association between the extent and definition of RSG and reported complications, as well as the approach used. Mean age at diagnosis was 55.3 ± 3.58 years, and most cases were found in women (83.3 %). The clinical picture of retrosternal goitre was dominated by compressive disorders. The length of stay in the hospital was 8.6 days (range, 4-11 days) and mean follow up was 24.3 months ( range, 4-39 months) Conclusions: In all the patients the symptoms caused by the Retrosternal goitre were disappeared following the resection of the swelling. Decision making in such patients should be individualized.