THE SPECIFIC MORBIDITY OF SUBSTERNAL GOIT ERS - A COMPARATIVE AND MATCHED STUDY WITH CERVICAL GOITERS

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.