Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations

Vasileios Leivaditis; Elias Liolis; Nikolaos Baltayiannis; Pavlos Sarof; Alexandra Pagoulatou; Konstantinos Grapatsas; Andreas Antzoulas; Dimitrios Litsas; Panagiotis Dimitrios Papadopoulos; George Theofanis; Konstantinos Nikolakopoulos; Paraskevi Katsakiori; Athanasios Papatriantafyllou; Efstratios Koletsis; Marina Michalaki; Francesk Mulita

doi:10.5114/kitp.2025.154929

eISSN: 1897-4252
ISSN: 1731-5530

Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery

Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Contact Instructions for authors Publication charge Ethical standards and procedures

Editorial System

Submit your Manuscript

3/2025
vol. 22

Send email

Copy url:

abstract:

Review paper

Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations

Vasileios Leivaditis

¹

,

Elias Liolis

²

,

Nikolaos Baltayiannis

³

,

Pavlos Sarof

⁴

,

Alexandra Pagoulatou

⁵

,

Konstantinos Grapatsas

⁶

,

Andreas Antzoulas

⁷

,

Dimitrios Litsas

⁸

,

Panagiotis Dimitrios Papadopoulos

⁹

,

George Theofanis

⁷

,

Konstantinos Nikolakopoulos

¹⁰

,

Paraskevi Katsakiori

⁷

,

Athanasios Papatriantafyllou

¹

,

Efstratios Koletsis

¹¹

,

Marina Michalaki

¹²

,

Francesk Mulita

⁷

Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany
Department of Oncology, General University Hospital of Patras, Greece
Department of Thoracic Surgery, ’Metaxa’ Cancer Hospital, Piraeus, Greece
Department of Otorhinolaryngology. ‘Metaxa’ Cancer Hospital, Piraeus, Greece
Department of Anesthesiology, ’Metaxa’ Cancer Hospital, Piraeus, Greece
Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
Department of General Surgery, General University Hospital of Patras, Greece
Department of Surgery, General Hospital of Lamia, Greece
Department of Surgery, Spital Herisau, Appenzell Ausserrhoden, Switzerland
Department of Vascular Surgery, General University Hospital of Patras, Greece
Department of Cardiothoracic Surgery, General University Hospital of Patras, Greece
Department of Endocrinology, General University Hospital of Patras, Greece

Kardiochirurgia i Torakochirurgia Polska 2025; 22 (3): 174-181

DOI: https://doi.org/10.5114/kitp.2025.154929

Online publish date: 2025/10/29

View full text Get citation

EndNote

Papers, Reference Manager, RefWorks, Zotero

AMA

Leivaditis V, Liolis E, Baltayiannis N, et al. Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2025;22(3):174-181. doi:10.5114/kitp.2025.154929.

APA

Leivaditis, V., Liolis, E., Baltayiannis, N., Sarof, P., Pagoulatou, A.,  & Grapatsas, K. et al. (2025). Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 22(3), 174-181. https://doi.org/10.5114/kitp.2025.154929

Chicago

Leivaditis, Vasileios, Elias Liolis, Nikolaos Baltayiannis, Pavlos Sarof, Alexandra Pagoulatou, Konstantinos Grapatsas,  and Andreas Antzoulas et al. 2025. "Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations". Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery 22 (3): 174-181. doi:10.5114/kitp.2025.154929.

Harvard

Leivaditis, V., Liolis, E., Baltayiannis, N., Sarof, P., Pagoulatou, A., Grapatsas, K., Antzoulas, A., Litsas, D., Papadopoulos, P., Theofanis, G., Nikolakopoulos, K., Katsakiori, P., Papatriantafyllou, A., Koletsis, E., Michalaki, M.,  and Mulita, F. (2025). Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 22(3), pp.174-181. https://doi.org/10.5114/kitp.2025.154929

MLA

Leivaditis, Vasileios et al. "Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations." Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, vol. 22, no. 3, 2025, pp. 174-181. doi:10.5114/kitp.2025.154929.

Vancouver

Leivaditis V, Liolis E, Baltayiannis N, Sarof P, Pagoulatou A, Grapatsas K et al. Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2025;22(3):174-181. doi:10.5114/kitp.2025.154929.

PlumX metrics:

A goiter is defined as an enlargement of the thyroid gland, typically resulting in a doubling in size or a weight exceeding 40 g. It affects approximately 5% of the global population. Diving, or substernal, goiters occur when more than 50% of the thyroid extends into the mediastinum, with an incidence ranging from 5% to 15.7% across various studies. An alternative definition describes diving goiters as those extending more than 3 cm below the sternal notch on chest computed tomography with the neck in hyperextension, or beyond the fourth thoracic vertebra. In this review, we outline the key clinical and radiological criteria that indicate when sternotomy is required for the surgical management of diving goiters.

keywords:

Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations

diving goiter, substernal goiter, intrathoracic thyroid, sternotomy, thyroid surgery, mediastinal goiter