Il trattamento del gozzo immerso. La nostra esperienza

Published on Jan 1, 2003in Il Giornale di chirurgia
Maria Adelfina Barbuscia4
Estimated H-index: 4
,
C. Praticò7
Estimated H-index: 7
+ 5 AuthorsSalvatore Gorgone4
Estimated H-index: 4
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Abstract
Gli Autori, dopo avere accennato alla storia naturale del gozzo immerso, riferiscono la loro esperienza di tale patologia maturata negli ultimi 5 anni, sottolineando i caratteri della complessa sintoma - tologia osservata nei vari casi, la condotta terapeutica seguita, i buoni risultati ottenuti. Si soffermano quindi ad elencare le molteplici classificazioni, via via proposte. Illustrano le complesse situazioni sia di ordine emodina - mico che respiratorio di particolare interesse anestesiologico. Discutono, infine, sulla diagnostica e soprattutto sul corretto atteggiamento terapeutico il cui obiettivo e duplice: risolvere la sinto - matologia prodotta dalla massa mediastinica ed escludere la possibi - lita di recidive
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#1Gennaro FaviaH-Index: 26
#2Franco LumachiH-Index: 32
Last. D. F. D'AmicoH-Index: 13
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1 Citations
Objective: Clinical picture and surgical management of 175 mediastinal goiters are discussed in this retrospective study. Method: Between 1979 and 1996, 175 patients with intrathoracic goiters were operated on at the Thoracic Surgical Clinic in Budapest. The majority of the goiters were cervicomediastinal (n = 138, 79%), past the level of aortic arch, and the others were complete aberrant lesions ( n = 37, 21%). Of the patients, 40% (n = 70) were symptom-free, in the others the clinical picture ...
82 CitationsSource
#1Jacqueline Jonklaas (GUMC: Georgetown University Medical Center)H-Index: 30
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3 CitationsSource
#1De Medici AH-Index: 3
#2Mottola PH-Index: 2
Last. Bargiggia CH-Index: 1
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: Among 660 cases of thyroid pathology diagnosed by the 2nd Institute of Clinical Surgery, Policlinico San Matteo, IRCCS, Pavia, during the period 1984 to 1993, 34 cases of cervical-mediastinal goiter were observed with an incidence of 5%. After a careful analysis of the main contributions to the study of cervical-mediastinal goiters, paying special attention to their classification, pathogenesis, methods of growth, and unique symptomatic manifestations, the authors focus on current radiological...
1 Citations
#1Belardinelli L (Sapienza University of Rome)H-Index: 1
#1Belardinelli LH-Index: 1
Last. Giuseppe PappalardoH-Index: 15
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: Computed Tomography (CT) and Magnetic Resonance (MR) permit the acquirement of important diagnostic elements for the anatomo-topographic staging of substernal goiters, and for their characterization. The authors compared data obtained by CT and MR with intraoperative anatomo-topographic findings and definitive histology in 28 patients with substernal goiters. CT was performed in all these patients while MR only in 9. The results obtained showed an accuracy of 85.7% for CT and 100% for MR regar...
22 Citations
#1Laura E. SandersH-Index: 9
#2Ricardo L. RossiH-Index: 38
Last. Warren A. WilliamsonH-Index: 13
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• We reviewed the cases of 52 patients with substernal goiters to examine clinical presentation, workup, technique of removal, malignancy, and outcome. Half of the patients were asymptomatic; half had at least one compressive symptom. Chest film was the most used; computed tomography or magnetic resonance imaging was by far the most useful study. Thyroid scans often failed to show the intrathoracic goiter. Fine-needle aspiration was not helpful because of the gland's inaccessibility. Seventeen p...
68 CitationsSource
#1Maruotti Ra (University of Milan)H-Index: 3
#2Piero Zannini (UniSR: Vita-Salute San Raffaele University)H-Index: 29
Last. Giuseppe Pezzuoli (University of Milan)H-Index: 12
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: Fifty-one patients (4.6%) underwent resection of a substernal goiter in a fifteen-year period during the course of 1103 thyroidectomies. Forty-eight (94.2%) goiters were benign and three (5.8%) malignant. Mean age was 55 years. Female:male ratio was 2:1. Four patients (7.8%) had undergone prior thyroid surgery. Most had long-standing goiters (mean duration: 15 years). The most common symptoms included airway compression (56.8%), hoarseness (13.7%), dysphagia (11.7%), superior vena cava syndrom...
37 Citations
1 Citations
#1Janati ImH-Index: 1
#2Jancovici RH-Index: 1
Last. Cosnard GH-Index: 1
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: Two groups of substernal goiters should be considered fist; the "simples" ones localised in the anterior and superior part of the mediastin. They are most common and less dangerous. By opposition to the "complexes" ones which have relation with the vessels, the airways and the digestive tube. That surgeons would like to approach with security. The study of those retrosternal goiters requires two categories of complementary examinations. One for diagnosis: X Ray standard of the neck and the che...
1 Citations
#1Arie BerghoutH-Index: 5
#2Wilmar M. WiersingaH-Index: 74
Last. Hemmo A. Drexhage (EUR: Erasmus University Rotterdam)H-Index: 59
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Abstract The efficacy of treatment with TSH-suppressive doses of L-thyroxine (T4, 2·5 μg/kg body weight daily) either alone or combined with carbimazole (CBZ, 40 mg daily) was studied in 78 patients with sporadic non-toxic goitre in a prospective placebo-controlled double-blind randomised clinical trial. Treatment was given for 9 months, with 9 months of follow-up. A response to treatment as measured by ultrasonography was found in 58% of the T4 group, in 35% of the T4/CBZ group, and in 5% of th...
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Background: The definition of substernal goiter is not uniform and varies among authors. We can define substernal - or retroster- nal - goiter a thyroid formation with cervical de- parture that goes beyond the superior thoracic strait for at least 3 cm and that preserves, general- ly, the connections between the cervical and tho- racic portion, maintaining a direct vascularization supplied by the thyroid arteries. The "forgotten" goiter is an extremely rare disease: a mediastinic thyroid mass fo...
17 Citations