Document Type : Original Article


1 Consultant of Thoracic Surgery

2 Consultant Anesthesia and Pain Management

3 Consultant General Surgery, Military Medical Academy, Cairo, 11291, Egypt


The study was carried out on 40 patients presented with thyroid swelling admitted at Kobry
El-Kobba Military Medical Compass over two years. Eighteen of them suffered from retrosternal
goiter and were divided into two groups. GI: 4 males were treated by sternotomy and
total thyroidectomy, which histopathological examination showed multinodular goiter. GII: 14
patients (12 males & 2 females) were treated by cervical incision and manual retrosternal goiter
deli- very. Patients in both groups were followed up 2 weeks over three months and then
one month over a year post-operation for thyroid profile, serum Ca level, and histopathological
specimens showed multinodular goiter without malignancy.
In GI, one patient developed wound secondary infection and was treated by antibiotic. Another
one showed post-operative hypocalcemia and was treated by oral vitamin D and Ca 500
mg and improved after 6 months. In GII, six male patients showed complications; two showed
transient hypocalcemia post-operative and were treated by I.V. Ca gluconate 10% every 12hr
for 2 days followed by oral Ca every 12hr for another week and then one vitamin D and one
Ca- tablet for 6 months. One patient showed neck hematoma and exploration was done to
evacuate hematoma and bleeding control. Two patients showed nerve problem in the form of
voice change, difficult in swallowing and aspiration. One was managed by endotracheal intubation
for 48hr and the second was managed by Oxygen therapy and steroid. One patient
showed mild infection and skin edema that was managed by antibiotic and anti-edematous
agent. The last one showed sinus formation and was treated by curettage and antibiotic. The
hospital stay was long in GI than in GII, as in GI 48hr ventilation used post-operative compared
to 24hr in GII, but neither tracheomalacia treatment nor tracheostomy in both groups.