caa a22 4500 445336331 CHVBK 20180317142756.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1596-4 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1596-4 Does Mediastinal Extension of the Goiter Increase Morbidity of Total Thyroidectomy? A Multicenter Study of 19,662 Patients [Elektronische Daten] [Mario Testini, Angela Gurrado, Nicola Avenia, Rocco Bellantone, Antonio Biondi, Paolo Brazzarola, Filippo Calzolari, Giuseppe Cavallaro, Giorgio De Toma, Pietro Guida, Germana Lissidini, Michele Loizzi, Celestino Lombardi, Giuseppe Piccinni, Piero Portincasa, Lodovico Rosato, Nora Sartori, Chiara Zugni, Francesco Basile] Purpose: To compare the outcome in patients with cervical goiters and cervicomediastinal goiters (CMGs) undergoing total thyroidectomy using the cervical or extracervical approach. Methods: This was a retrospective study conducted at six academic departments of general surgery and one endocrine-surgical unit in Italy. The study population consisted of 19,662 patients undergoing total thyroidectomy between 1999 and 2008, of whom 18,607 had cervical goiter (group A) and 1055 had CMG treated using a cervical approach (group B, n=986) or manubriotomy (group C, n=69). The main parameters of interest were symptoms, gender, age, operative time, duration of drain, length of hospital stay, malignancy and outcome. Results: A split-sternal approach was required in 6.5% of cases of CMG. Malignancy was significantly more frequent in group B (22.4%) and group C (36.2%) versus group A (10.4%; both P<.001), and in group C versus group B (P=.009). Overall morbidity was significantly higher in groups B+C (35%), B (34.4%) and C (53.5%) versus group A (23.7%; P<.001). Statistically significant increases for group B+C versus group A were observed for transient hypocalcemia, permanent hypocalcemia, transient recurrent laryngeal nerve (RLN) palsies, permanent RLN palsies, phrenic nerve palsy, seroma/hematoma, and complications classified as other. With the exception of transient bilateral RLN palsy, all of these significant differences between group B+C versus group A were also observed for group B versus group A. Conclusions: Symptoms, malignancy, overall morbidity, hypoparathyroidism, RLN palsy and hematoma are increased in cases of substernal goiter. Society of Surgical Oncology, 2011 Testini Mario Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut Gurrado Angela Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut Avenia Nicola Department of Surgery, Thoracic Surgery Unit, University Medical School of Perugia, Perugia, Italy aut Bellantone Rocco Department of Surgery, Unit of Endocrine Surgery, University Medical School "Cattolica del Sacro Cuore”, Rome, Italy aut Biondi Antonio Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Catania, Italy aut Brazzarola Paolo Department of Surgery, University Medical School of Verona, Verona, Italy aut Calzolari Filippo Department of Surgery, Thoracic Surgery Unit, University Medical School of Perugia, Perugia, Italy aut Cavallaro Giuseppe Department of Surgery, Unit of General Surgery "P. Valdoni”, University Medical School "La Sapienza”, Rome, Italy aut De Toma Giorgio Department of Surgery, Unit of General Surgery "P. Valdoni”, University Medical School "La Sapienza”, Rome, Italy aut Guida Pietro Cardiology Unit, Emergency and Organ Transplantation Department, University Medical School of Bari, Bari, Italy aut Lissidini Germana Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut Loizzi Michele Department of Application in Surgery of Innovative Technologies, Section of Thoracic Surgery, University Medical School of Bari, Bari, Italy aut Lombardi Celestino Department of Surgery, Unit of Endocrine Surgery, University Medical School "Cattolica del Sacro Cuore”, Rome, Italy aut Piccinni Giuseppe Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut Portincasa Piero Department of Internal Medicine and Public Medicine, Clinica Medica "A. Murri,” University Medical School of Bari, Bari, Italy aut Rosato Lodovico Department of Surgery, Endocrine Surgical Unit, Ivrea Hospital, Ivrea, Torino, Italy aut Sartori Nora Department of Surgery, University Medical School of Verona, Verona, Italy aut Zugni Chiara Department of Surgery, University Medical School of Verona, Verona, Italy aut Basile Francesco Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Catania, Italy aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2251-2259 1068-9265 18:8<2251 2011 18 10434 https://doi.org/10.1245/s10434-011-1596-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1596-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Testini Mario Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Gurrado Angela Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Avenia Nicola Department of Surgery, Thoracic Surgery Unit, University Medical School of Perugia, Perugia, Italy aut NATIONALLICENCE 700 1- Bellantone Rocco Department of Surgery, Unit of Endocrine Surgery, University Medical School "Cattolica del Sacro Cuore”, Rome, Italy aut NATIONALLICENCE 700 1- Biondi Antonio Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Catania, Italy aut NATIONALLICENCE 700 1- Brazzarola Paolo Department of Surgery, University Medical School of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Calzolari Filippo Department of Surgery, Thoracic Surgery Unit, University Medical School of Perugia, Perugia, Italy aut NATIONALLICENCE 700 1- Cavallaro Giuseppe Department of Surgery, Unit of General Surgery "P. Valdoni”, University Medical School "La Sapienza”, Rome, Italy aut NATIONALLICENCE 700 1- De Toma Giorgio Department of Surgery, Unit of General Surgery "P. Valdoni”, University Medical School "La Sapienza”, Rome, Italy aut NATIONALLICENCE 700 1- Guida Pietro Cardiology Unit, Emergency and Organ Transplantation Department, University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Lissidini Germana Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Loizzi Michele Department of Application in Surgery of Innovative Technologies, Section of Thoracic Surgery, University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Lombardi Celestino Department of Surgery, Unit of Endocrine Surgery, University Medical School "Cattolica del Sacro Cuore”, Rome, Italy aut NATIONALLICENCE 700 1- Piccinni Giuseppe Department of Biomedical Sciences and Human Oncology, Section of General Surgery and Clinical Oncology, University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Portincasa Piero Department of Internal Medicine and Public Medicine, Clinica Medica "A. Murri,” University Medical School of Bari, Bari, Italy aut NATIONALLICENCE 700 1- Rosato Lodovico Department of Surgery, Endocrine Surgical Unit, Ivrea Hospital, Ivrea, Torino, Italy aut NATIONALLICENCE 700 1- Sartori Nora Department of Surgery, University Medical School of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Zugni Chiara Department of Surgery, University Medical School of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Basile Francesco Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Catania, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2251-2259 1068-9265 18:8<2251 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer