Cervicotomy using a hemi-clamshell approach for a rare enlarged substernal goitre.

The substernal goitre is defined as a goitre for which >50% of the mass is located below the superior orifice of the thorax, surgical resection remains the reference treatment, the approach used is the cervicotomy, which often allows to extract the mediastinal portion of the plunging goitre, and we report a rare case of a huge cancerous plunging goitre whose complete resection required the enlargement of the cervicotomy in right hemi-clamshell, for the carcinological, vascular and recurrent control.

Multi-segmental reverse loops for long-segment, supercharged pedicled ileum graft for total oesophageal reconstruction: an alternative for anisoperistaltic ileum graft.

In this article, a new technique for turn-over jejunal graft without kinking of its mesenteric vessels is described. Graft necrosis occurred on a left colon oesophageal reconstruction performed for a 56-year-old-woman. A salvage oesophageal reconstruction was performed by a long-segment, supercharged, pedicled anisoperistaltic ileum. Regurgitations were permanent in spite of medical treatment. Segmental reverse of ileum loops was used to turn over the direction of peristaltism without mesenteric twisting. The technique has never been described previously.