COMPLICATIONS OF RETROSTERNAL GOITRE SURGERY: A RETROSPECTIVE ANALYSIS
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Keywords
Retrosternal goitre, thyroidectomy, surgical complications, hypoparathyroidism, recurrent laryngeal nerve injury, tracheomalacia, tracheopexy
Abstract
Background: Retrosternal goitre (RSG) represents a unique surgical challenge due to its mediastinal extension and proximity to vital structures. This study evaluates the complications associated with RSG surgery and identifies factors influencing postoperative outcomes.
Methods: A retrospective analysis was conducted on 73 patients who underwent thyroidectomy for retrosternal goitre between 3rd June 2014 and 14th February 2022. Data on patient demographics, surgical approach, and postoperative complications were collected and analyzed. Complications assessed included recurrent laryngeal nerve injury, hypoparathyroidism, bleeding, wound infection, and respiratory complications.
Results: A total of 73 patients were included. The cervical approach alone was successful in 68 (93.2%) cases, while 5 (6.8%) patients required mediastinotomy; no patient required sternotomy. The overall complication rate was 24.7%, with transient hypocalcaemia being the most common (12.3%), followed by transient hoarseness (5.5%). Transient tracheomalacia occurred in 3 patients (4.1%), partial tracheomalacia in 1 patient (1.4%), and permanent hypoparathyroidism in 1 patient (1.4%). Tracheopexy was performed in 8 patients (11.0%). No tracheostomy was performed. No permanent recurrent laryngeal nerve palsy was observed.
Conclusion: Surgery for retrosternal goitre carries a risk of complications including transient hypocalcaemia, transient recurrent laryngeal nerve injury, and respiratory complications. The cervical approach remains the gold standard and was successful in all cases. Meticulous surgical technique and preoperative planning are essential for optimizing outcomes.
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