胸骨后甲状腺肿16例诊治分析

Diagnosis and surgical management for retrosternal goiter

目的：探讨胸骨后甲状腺肿的诊断及外科治疗方法。方法：回顾性分析2002年1月2009年4月我院收治的16例胸骨后甲状腺肿患者临床资料。结果：16例患者均行手术切除胸骨后甲状腺肿物,11例（68.8%）经颈部低位领式切口,3例（18.8%）单纯纵劈胸骨,2例（12.4%）经颈部低位领式切口加胸骨劈开,病理证实为结节性甲状腺肿11例（68.8%）,滤泡性腺瘤5例（31.2%）,其中有2例局部微小癌形成。术后并发迟发的胸骨后血肿1例。无其他严重并发症和手术死亡病例。结论：CT检查有助于胸骨后甲状腺肿的诊断和术前评估。经颈部低位领式切口入路手术切除胸骨后甲状腺肿适用于大部分病例,手术创伤较小,安全可靠。

Objective： To study the diagnosis and surgical management for retr-osternal goiter.Methods： A retrospective analysis of patients with resected retro-sternal goiter at our department between January 2002 and April 2009 was performed.Results： The operations on 16 cases with retrosternal goiter have been successfully carried out.11 of 16 cases（68.8percent）were approached through the cervical collar incision.3 of 16 cases（18.8 percent）were approached through the sternotomy,and 2 cases through the ap-proach combined the cervical collar incision and sternotomy.Pathologic examination revealed multinodular goiter in 11（68.8percent）,follicular adenoma in 5（31.2percent）,2 of which were found minimum cancerogenesis.One cases complicated tardus retrosternal hema-toma.There were no deaths or other major complications.Conclusion： Preoperative CT scanning were helpful in diagnosis and evaluating the extent of retrosternal goiter.Resection of substemal goiter through the cervical collar incision was proved to be feasible and safe on the majority of patients.