Source:http://linkedlifedata.com/resource/pubmed/id/11893102
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
3
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pubmed:dateCreated |
2002-3-14
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pubmed:abstractText |
Patients with substernal thyroid disease, defined by the presence of enlarged thyroid tissue below the plane of the thoracic inlet, were identified from a prospective database maintained for patients who have undergone thyroidectomy at our institution since 1990. Substernal thyroid disease was present in 116 (30%) of 381 patients, anterior mediastinal in 109 (94%), and posterior mediastinal in seven (6%). Indications for surgery included compressive symptoms in 75 (65%) patients, an abnormal fine-needle biopsy in 45 (39%), progressive thyroid enlargement in 41 (35%), thyrotoxicosis in 11 (10%), and superior vena cava syndrome in two (1.7%). A median sternotomy and thoracotomy were performed in one patient each for a primary intrathoracic goiter. In all other patients thyroidectomy was accomplished through a cervical incision. Parathyroid autotransplantation was performed in 41 (37%) patients with retrosternal disease compared with 57 (22%) with disease confined to the neck (P < 0.01). Twenty-five patients (22%) had malignancy; four of these had unresectable disease. Postoperative complications included transient hypocalcemia (n = 46), transient hoarseness (n = 7), recurrent laryngeal nerve injury (n = 1), and wound infection (n = 1). One patient died from aspiration pneumonia. In summary, substernal thyroid disease is typically present in the anterior mediastinum and with rare exceptions can be resected through a cervical incision. Parathyroid devascularization is more common with resection of a substernal goiter and autotransplantation can prevent permanent hypoparathyroidism.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Mar
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pubmed:issn |
0003-1348
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
68
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
245-51; discussion 251-2
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:11893102-Adolescent,
pubmed-meshheading:11893102-Adult,
pubmed-meshheading:11893102-Aged,
pubmed-meshheading:11893102-Aged, 80 and over,
pubmed-meshheading:11893102-Child,
pubmed-meshheading:11893102-Female,
pubmed-meshheading:11893102-Follow-Up Studies,
pubmed-meshheading:11893102-Goiter, Nodular,
pubmed-meshheading:11893102-Goiter, Substernal,
pubmed-meshheading:11893102-Humans,
pubmed-meshheading:11893102-Male,
pubmed-meshheading:11893102-Middle Aged,
pubmed-meshheading:11893102-Postoperative Complications,
pubmed-meshheading:11893102-Probability,
pubmed-meshheading:11893102-Prospective Studies,
pubmed-meshheading:11893102-Registries,
pubmed-meshheading:11893102-Risk Assessment,
pubmed-meshheading:11893102-Severity of Illness Index,
pubmed-meshheading:11893102-Thyroidectomy,
pubmed-meshheading:11893102-Tomography, X-Ray Computed,
pubmed-meshheading:11893102-Treatment Outcome
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pubmed:year |
2002
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pubmed:articleTitle |
The clinical presentation and operative management of nodular and diffuse substernal thyroid disease.
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pubmed:affiliation |
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109-1998, USA.
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pubmed:publicationType |
Journal Article,
Comparative Study
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