A case of mediastinal goiter treated surgically using a clavicle-lifting technique. (2015)

• Record Type: Journal Article
• Authors: Ito, Eisaku; Ohdaira, Hironori; Yasuda, Jungo; Yoshida, Masashi; Suzuki, Yutaka
• Is Part Of: International journal of surgery case reports. Volume 16(2015)Supplement
• Page Start: 12
• Page End: 14
• Publication Date: 2015
• Subjects: Mediastinal goiter -- Clavicle lifting technique; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2015.09.010
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: A thyroidectomy is indicated in all cases of mediastinal goiter because of the risks of airway obstruction, potential malignancy, tracheomalacia and invasion into the adjacent structures. The clavicle-lifting technique is a simple and safe technique that involves lifting the clavicles with a pediatric extension retractor (Kent Retractor Set, Takasago Medical Industry, Tokyo, Japan). The clavicle-lifting technique is a good surgical option for upper-mediastinal lesions such as mediastinal goiters and it obviates the need for a sternotomy. Abstract: Introduction: Mediastinal goiter is a benign disease, which is defined as a goiter with the greater portion of its mass lying below the thoracic inlet. It is controversial whether the cervical approach is the best approach for all mediastinal goiter surgeries. Case presentation: A 71-year-old woman presented with respiratory discomfort during exertion. Computed tomography (CT) revealed a mediastinal goiter extending to the arch of the aorta. Surgical resection was performed using a clavicle-lifting technique. The excised specimen was 13 × 10 × 5 cm in size and weighed 220 g. The pathological diagnosis was nodular goiter. Discussion: The clavicle-lifting technique is a simple and safe technique that involves lifting the clavicles with a pediatric extension retractor (Kent Retractor Set, Takasago Medical Industry, Tokyo, Japan). This is a good choice for surgery on upper mediastinal lesions such as mediastinal goiters as it obviates the need for a median sternotomy. Conclusion: Although further study is necessary, it appears that a transcervical approach using the clavicle-lifting technique may be an acceptable treatment for mediastinal goiters that extend to the aortic arch.