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Sridhar Rathinam
Ben Davies
Joseph F. Khalil-Marzouk
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Ann Thorac Surg 2006;82:759-760
© 2006 The Society of Thoracic Surgeons

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Marzouk's Procedure: A Novel Combined Cervical and Anterior Mediastinotomy Technique to Avoid Median Sternotomy for Difficult Retrosternal Thyroidectomy

Sridhar Rathinam, FRCS (Ed), Ben Davies, MRCS (Eng), Joseph F. Khalil-Marzouk, MCh, FRCS (CTh)*

Regional Department of Thoracic Surgery, Birmingham Heartlands Hospital, Birmingham, United Kingdom

Accepted for publication July 5, 2005.

* Address correspondence to Dr Khalil-Marzouk, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry, United Kingdom CV2 2DX. (Email: khalilmarzouk{at}btinternet.com).

Surgery for retrosternal goiter is uncommon. Most of the benign retrosternal goiters can be delivered and resected through a standard cervical incision. However, there are cases in which resection of the retrosternal goiter requires additional thoracic access to the standard transverse cervical incision in the form of partial or complete median sternotomy or even a thoracotomy. We propose and describe a novel technique of combining anterior mediastinotomy to the cervical incision as an adjunct to facilitate delivering the difficult retrosternal goiter by bi-manual manipulation. This technique avoids the trauma and postoperative morbidity of a median sternotomy or thoracotomy and proves effective in solving the technical, functional, financial, and aesthetic problems.






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