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 language | English |
|---|---|
| Pages (from-to) | 1662-1668 |
| Number of pages | 7 |
| Journal | Journal of Pediatric Surgery |
| Volume | 47 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Sep 2012 |
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Keywords
- Childhood thoracic inlet tumors
- Complications
- Sternotomy
- Surgical risk factors
- Trap-door incision
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
The surgical approach for cervicothoracic masses in children. / De Corti, Federica; Avanzini, Stefano; Cecchetto, Giovanni; Buffa, Piero; Guida, Edoardo; Zanon, Giovanni F.; Jasonni, Vincenzo.
In: Journal of Pediatric Surgery, Vol. 47, No. 9, 09.2012, p. 1662-1668.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The surgical approach for cervicothoracic masses in children
AU - De Corti, Federica
AU - Avanzini, Stefano
AU - Cecchetto, Giovanni
AU - Buffa, Piero
AU - Guida, Edoardo
AU - Zanon, Giovanni F.
AU - Jasonni, Vincenzo
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
KW - Childhood thoracic inlet tumors
KW - Complications
KW - Sternotomy
KW - Surgical risk factors
KW - Trap-door incision
UR - http://www.scopus.com/inward/record.url?scp=84866245267&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84866245267&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2012.03.087
DO - 10.1016/j.jpedsurg.2012.03.087
M3 - Article
C2 - 22974603
AN - SCOPUS:84866245267
VL - 47
SP - 1662
EP - 1668
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 9
ER -