Bocio del mediastino posterior - abordaje mínimamente invasivo: videotoracoscopia derecha más cervicotomía

David Rodriguez Ramos, Veronica Acevedo Mejía, Ricardo Zapata Gonzalez, Luis Bolivar Mendoza, Carlos Saldarriaga Henao

Resumen


La cirugía es el manejo recomendado para el bocio intratorácico y cerca de un 90 % de ellos pueden resecarse mediante cervicotomía. El bocio en el mediastino posterior ha sido manejado satisfactoriamente empleando diversos abordajes cervicotorácicos, existiendo poca información en la literatura acerca del uso de la videotoracoscopia como parte de estas técnicas combinadas.

Presentamos el caso de un paciente con un bocio intratorácico con extensión a mediastino posterior, en quien, dadas las características de la masa y su localización, sumado a las ventajas ampliamente conocidas de la cirugía mínimamente invasiva, se decide remplazar la toracotomía y la esternotomía por la videotoracoscopia, permitiendo una buena exposición y disección segura del mediastino.

Consideramos que la videotoracoscopia es una técnica segura y efectiva en casos seleccionados de pacientes con bocio con extensión a mediastino posterior.

Abstract

Surgery is the recommended treatment for intrathoracic goiter. About 90 % of the lessons can be resected by cervicotomy. The posterior mediastinal goiter was been successfully managed using different cervico-thoracic approaches; however, there is little available information in the literature about the use of videothoracoscopy as part of these combined techniques. We present a case of a patient with intrathoracic goiter extended to the posterior mediastinum, in which, given the characteristics of the mass and its location added to the widely known benefits of minimally invasive surgery, it was decided to replace thoracotomy and sternotomy with videothoracoscopy allowing good exposure and safe dissection of the mediastinum.

We consider that videothoracoscopy is a safe and effective technique in selected cases of patients with goiter extending into the posterior mediastinum.

DOI: http://dx.doi.org/10.21615/cesmedicina.30.2.8

 


Palabras clave


Bocio Subesternal, Toracoscopía, Toracotomía, Esternotomía

Citas


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