P. Goudet et al., THE SPECIFIC MORBIDITY OF SUBSTERNAL GOIT ERS - A COMPARATIVE AND MATCHED STUDY WITH CERVICAL GOITERS, Annales de chirurgie, 50(10), 1996, pp. 913-917
The operative morbidity rates in patients operated for substernal goit
er (SG) vary from one series to another. The aim of this study was to
reevaluate the morbidity using a matched technique. Each SG was matche
d to a cervical goiter for surgical technique, histology and thyroid f
unction. There were 97 SG (75 % of women), 43 % with normal thyroid fu
nction, 28 % with mild hyperthyroidism, 29 % with hyperthyroidism. 87
% of thyroidectomies were bilateral. Mean age was 66.5 +/- 11.5 years
versus 55.8 +/- 11.9 years for cervical goiters (p < 0.001). The perce
ntage of men was higher for SG than for cervical goiter (25 % Versus 1
0 %, p < 0.01). Specimen weighed 166 +/- 109 g versus 76 +/- 95 g (p <
0.0001). Total volume of drainage was 164.0 +/- 68 ml versus 123.2 +/
- 68 ml (p = 0.003). No operative death occurred. Early hypoparathyroi
dism rate was 3 % versus 2 % (p = 0.5), and late hypoparathyroidism wa
s 1 % versus 0 % (p = 0.5). There was a 10 mg/l in serum calcium posto
perative drop in both groups but no change in serum phosphate was note
d (bilateral thyroidectomies). The early recurrent laryngeal nerve pal
sy rate was 4 % versus 0 % (p = 0.06) and 3 % versus 0 % one year late
r (p = 0.12). Early postoperative reoperation rate for hemostasis was
2 % Versus 1 % respectively (p = 0.25). We conclude that there is no s
ignificant difference in surgical morbidity between thyroidectomies fo
r SG and cervical goiters when patients are operated in specialized ce
nters. Operative fears are not justified.