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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors make an analysis of the experience accumulated in the Clinic for Thoracic Surgery of Bucharest as a result of the surgical treatment of 16 patients endothoracic goiters. The authors stress the fact that these goiters should be differentiated from the "plunging goiter" variety, by their symptomatology, and by the different way of approaching their treatment. The diagnostic difficulties are stressed, especially since the uptake of iodine (radioactive iodine) can be negative in the endothoracic goiter of the functional type. The authors prefer thoracotomy, while the sternotomy is reserved only for the endothoracic goiters in the median area. The immediate results have been good in 15 cases. One patient died as a result of toxi-infectious phenomena.
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PMID:[Surgical treatment of endothoracic goiter]. 645 11

In the Department of General and Thoracic Surgery between 1981 and 1992 497 patients with tracheal stenosis were treated surgically. In 19 (3.8%) cases the stenosis was after previous tracheostomy. In 469 patients (94.4%) the stenosis was caused as the result of compression by goitre and in 9 (1.8%) by neoplastic tumors of mediastinum. Most patients with tracheal stenosis were treated surgically. In 13 cases the stenosis was resected, in 3 cases T-tube was inserted and in 3 cases the stenosis was dilated. In patients with secondary stenosis due to compression by goitre subtotal thyroidectomy was performed. Early good immediate results in both groups of tracheal stenosis were obtained in 90% of cases. Late results obtained 12 months after treatment of primary tracheal stenosis and 4 to 48 months after treatment of secondary tracheal stenosis (due to goitre) revealed 90% of good results.
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PMID:[Surgical treatment of tracheal stenosis]. 865 68

Sixty-one patients with substernal goiter--42 women and 9 men (female:male ratio 2.2:1), mean age 57.5 years--underwent surgical resection in the General and Thoracic Surgery Division of the Surgery Department of the University of Catania from January 1980 to March 1999. Six patients (9.8%) had previously undergone cervicotomy. Forty-nine patients (80.3%) had symptoms (2 with acute respiratory failure); 22.9% had metabolic symptoms. Fifty-one patients (83.6%) had cervicomediastinal goiter, 8 (13.1%) migrated mediastinal goiter and 2 (3.3%) ectopic goiter. Forty-one cases (69.5%) were prevascular and 18 (30.5%) retrovascular; of the latter 5 were pre-visceral and 13 retrovisceral. Fifty-one thyroidectomies (6 subtotal) were performed, as well as 5 mediastinal excisions to complete removal and 4 resections confined to the mediastinal component. The 51 patients with cervicomediastinal goiter underwent cervicotomy in 42 cases (82.4%), cervicosternotomy in 7 cases (13.7%) and cervicosternothoracotomy in 2 cases (3.9%). The 8 migrated mediastinal goiters were removed via sternotomy in 6 cases, cervico thoracotomy in 1 and thoracotomy in 1. This latter approach was also used for the 2 ectopic goiters. The goiter presented signs of neoplastic degeneration in 2 cases (3.2%). Postoperative complications were: recurrent nerve palsy in 5 cases (1 bilateral definitive, 1 monolateral definitive, 3 monolateral transient), respiratory failure in 2, mediastinal hematoma in 1 and hypocalcemia in 8 (transient in 6). There was one postoperative death due to cardiorespiratory failure after cervicosternotomy. Surgical excision of substernal goiters is the best choice of treatment in view of the very low postoperative mortality and morbidity.
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PMID:[Intrathoracic goiter: experience with 61 surgically treated cases]. 1083 39

A 52-year-old woman was hospitalized because of dyspnea and dysphagia. Thoracic computed tomography revealed a retrotracheal mass. Tc-99m pertechnetate scintigraphy showed intense accumulation of radioactivity corresponding to the mediastinal mass detected by computed tomography. Repeated Tc-99m pertechnetate scintigraphy performed after oral administration of potassium perchlorate (KCLO4) revealed complete disappearance of the radioactive accumulation in the mediastinum, suggesting that the retrotracheal mass was a retrosternal goiter. Subsequent surgical removal and analysis of the mass showed it was indeed a retrosternal goiter. This case highlights the importance of Tc-99m pertechnetate thyroid scintigraphy with and without KCLO4 administration as a simple, accurate, and cost-effective imaging method to diagnose retrosternal goiter.
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PMID:Tc-99m pertechnetate scintigraphy before and after potassium perchlorate administration for the diagnosis of retrosternal goiter. 1083 97

Internal jugular vein thrombosis is a serious event with potentially fatal outcome, where the clinical symptoms may be vague or absent. This paper refers to a rare case where routine carotid Doppler ultrasound prior to coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in a 76-year-old man, incidentally revealed thrombosis of the right internal jugular vein. Thoracic CT demonstrated an underlying, large, benign substernal multinodular goiter, mainly involving the right lobe, causing compression and displacement of the great vessels. A successful, one-stage operation including ligation of the internal jugular vein to avoid pulmonary embolism and hemithyroidectomy, combined with the scheduled CABG and AVR, was performed. This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.
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PMID:Incidental detection of internal jugular vein thrombosis secondary to undiagnosed benign substernal goiter. 2081 60

Thoracic duct injury is uncommon in surgery of the neck: relatively more common after laryngeal and esophageal surgery, rare in thyroid surgery. From January 1986 to June 2009 were treated 14 patients with lesions of the cervical thoracic duct undergo surgery for thyroid disease: 4 goitre cervico-mediastinal and 10 total thyroidectomy for cancer, 9 of which have laterocervical left lymphadenectomy. In 2 cases, the intraoperative detection has allowed immediate ligature. In 12 patients a cervical chylous fistula without chilothorax was found: 5 low-flow fistulas and 7 high-flow fistulas. Of the 5 cases of low-flow fistula, 4 were recovered after 1 month of conservative treatment, only 1 patient required surgical correction. The 7 patients with high-flow fistula were undergoing surgery: 4 in the first week post-operative and 3 after a period of more than 30 days of medical therapy. In patients with high-flow fistula prolonged medical treatment does not provide benefit and increase the risk of complications during and after surgery.
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PMID:[Complications of thyroid surgery: cervical thoracic duct injuries]. 2093 53

Thoracic duct cysts in the mediastinum are rare. We report the case of a 66-year-old gentleman who was found to have multiple small thoracic duct cysts during investigation of a retrosternal thyroid goitre. Multiple paraoesphageal swellings were seen on a computed tomographic scan in the upper posterior mediastinum. The largest was 2 cm and they were continuous with the thoracic duct. This is this first reported case of multiple thoracic duct cysts. Previous cases are of a single large swelling, the majority of which were surgically excised. Small asymptomatic cysts such as the case we present are suitable for conservative management.
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PMID:Multiple thoracic duct cysts: an unusual CT finding. 2595 56

Between April 2016 and October 2017, we retrospectively reviewed all patients undergoing excision of large mediastinal masses using a hybrid robotic thoracic approach at the Unit of Thoracic Surgery of Monaldi Hospital in Naples. The inclusion criteria for this approach were: evident unilateral predominance of the mass; absence of invasion to surrounding structures. Planned conversion to sternotomy was necessary in one patient for tenacious adhesions between the mediastinal goiter and the left innominate vein. In all cases the postoperative course was uneventful. The hybrid robotic approach, adopted in our Unit, consists of a thoracic procedure performed completely with articulated surgical instruments under three-dimensional vision and followed by final extension of a port-site incision to retrieve the voluminous specimen. This approach uses all the advantages of robotic technology that enables to perform a fine dissection in the small space of the anterior mediastinum and at the same time, through the simple extension of a minimally invasive access, avoids the painful sequelae of thoracotomy. In selected cases, with increased experience in robotic surgery, it can be proposed for excision of large mediastinal masses, although a longer follow-up period is necessary to validate our findings.
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PMID:Hybrid robotic thoracic surgery for excision of large mediastinal masses. 2996 94