The surgical approach for cervicothoracic masses in children

Federica De Corti, Stefano Avanzini, Giovanni Cecchetto, Piero Buffa, Edoardo Guida, Giovanni F. Zanon, Vincenzo Jasonni

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The surgical approach to masses located in the cervicothoracic juncton represents a challenge for surgeons. Many techniques have been described with good results. Methods: We analyzed and compared the results obtained in 2 Italian pediatric surgery centers using 2 different techniques in patients with tumors of the thoracic inlet: center 1, using anterior cervical transsternal approach on 7 patients, and center 2, applying trap-door technique on 5 patients. Results: Excision was incomplete in 5 patients and complete in 7 patients. Histologic examination revealed 5 patients with neuroblastoma; 3, ganglioneuroblastoma; 1, mixoid liposarcoma; 1, desmoid fibromatosis; 1, Castleman disease; and 1, Schwann cell tumor. The median duration of the procedure was 345 minutes in center 1 and 245 minutes in center 2. The median blood loss was 200 mL in both centers. The median hospital stay was 11 days in center 1 and 9 days in center 2. Globally, 5 patients developed postoperative complications. No significant differences were encountered comparing the main surgical outcome parameters between the 2 approaches. Conclusions: Both techniques resulted in valid options to achieve a safe excision of thoracic inlet masses with a manageable complication rate and acceptable hospital stay. Surgical risk factors should be carefully investigated preoperatively. Postoperative pain control is important to guarantee early recovery.

Original languageEnglish
Pages (from-to)1662-1668
Number of pages7
JournalJournal of Pediatric Surgery
Volume47
Issue number9
DOIs
Publication statusPublished - Sep 2012

Keywords

  • Childhood thoracic inlet tumors
  • Complications
  • Sternotomy
  • Surgical risk factors
  • Trap-door incision

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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