Transmanubrial osteomuscular sparing approach for apical chest tumors

Dominique Grunenwald, Lorenzo Spaggiari

Research output: Contribution to journalArticlepeer-review


The transclavicular approach improved the treatment of apical chest tumors. However, removing the internal half of the clavicle and sectioning its muscular insertions led to serious postoperative alterations. We propose a transmanubrial approach, through a manubrial L-shaped transection and first costal cartilage resection, which allows retraction of an osteomuscular flap including but sparing the clavicle and all its muscular insertions. The elevation of the osteomuscular flap affords excellent access to the subclavicular region with safe control and resection of neurovascular outlet structures during the resection of apical chest tumors. Shoulder articulations and stability of the scapular girdle are respected, thus avoiding functional and cosmetic consequences of clavicle resection.

Original languageEnglish
Pages (from-to)563-566
Number of pages4
JournalAnnals of Thoracic Surgery
Issue number2
Publication statusPublished - Feb 1997

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery


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