Abstract
Background: The mini-ivasive approach to superior sulcus tumors is an uncommon procedure that is still far from standardization. We describe a hybrid surgical technique to approach "en block" chest resection and pulmonary lobectomy for anterior superior sulcus tumors. Case Presentation: A patient affected by right anterior Pancoast tumor surgically staged as cT4N0M0 (suspected anonymous vein invasion) underwent chemo-radiation induction therapy with satisfactory tumor reduction. The surgical operation comprised an initial VATS approach to the hilar structures followed by a limited C-shaped anterior contra-incision; finally, the right upper lobe "en block" with the anterior part of the first and second rib was removed. The whole procedure was conducted with the patient in the supine position; no rib retractors were used. The definitive stage was ypT0N0M0. The patient had an uneventful hospital stay and at the 9 months follow-up she was free from disease and post-thoracotomy syndrome. Conclusions: In our opinion such hybrid VATS procedure has several advantages: starting with thoracoscopy it is possibleto exclude previously undetected pleural dissemination and to precisely define the tumor location as well as limits of the thoracic wall resection; time could be spared maintaining the patients in the supine position for both surgical times; postoperative pain and post-thoracotomy syndrome could be minimized avoiding the use of any rib retractor.
| Original language | English |
|---|---|
| Article number | 65 |
| Journal | Journal of Cardiothoracic Surgery |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Apr 14 2016 |
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Keywords
- Anterior Pancoast
- Chest wall
- Lung cancer
- Transmanubrial approach
- VATS lobectomy
ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine
Cite this
Video-assisted pulmonary lobectomy combined with transmanubrial approach for anterior Pancoast tumor resection : Case report. / Rosso, Lorenzo; Palleschi, Alessandro; Mendogni, Paolo; Nosotti, Mario.
In: Journal of Cardiothoracic Surgery, Vol. 11, No. 1, 65, 14.04.2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Video-assisted pulmonary lobectomy combined with transmanubrial approach for anterior Pancoast tumor resection
T2 - Case report
AU - Rosso, Lorenzo
AU - Palleschi, Alessandro
AU - Mendogni, Paolo
AU - Nosotti, Mario
PY - 2016/4/14
Y1 - 2016/4/14
N2 - Background: The mini-ivasive approach to superior sulcus tumors is an uncommon procedure that is still far from standardization. We describe a hybrid surgical technique to approach "en block" chest resection and pulmonary lobectomy for anterior superior sulcus tumors. Case Presentation: A patient affected by right anterior Pancoast tumor surgically staged as cT4N0M0 (suspected anonymous vein invasion) underwent chemo-radiation induction therapy with satisfactory tumor reduction. The surgical operation comprised an initial VATS approach to the hilar structures followed by a limited C-shaped anterior contra-incision; finally, the right upper lobe "en block" with the anterior part of the first and second rib was removed. The whole procedure was conducted with the patient in the supine position; no rib retractors were used. The definitive stage was ypT0N0M0. The patient had an uneventful hospital stay and at the 9 months follow-up she was free from disease and post-thoracotomy syndrome. Conclusions: In our opinion such hybrid VATS procedure has several advantages: starting with thoracoscopy it is possibleto exclude previously undetected pleural dissemination and to precisely define the tumor location as well as limits of the thoracic wall resection; time could be spared maintaining the patients in the supine position for both surgical times; postoperative pain and post-thoracotomy syndrome could be minimized avoiding the use of any rib retractor.
AB - Background: The mini-ivasive approach to superior sulcus tumors is an uncommon procedure that is still far from standardization. We describe a hybrid surgical technique to approach "en block" chest resection and pulmonary lobectomy for anterior superior sulcus tumors. Case Presentation: A patient affected by right anterior Pancoast tumor surgically staged as cT4N0M0 (suspected anonymous vein invasion) underwent chemo-radiation induction therapy with satisfactory tumor reduction. The surgical operation comprised an initial VATS approach to the hilar structures followed by a limited C-shaped anterior contra-incision; finally, the right upper lobe "en block" with the anterior part of the first and second rib was removed. The whole procedure was conducted with the patient in the supine position; no rib retractors were used. The definitive stage was ypT0N0M0. The patient had an uneventful hospital stay and at the 9 months follow-up she was free from disease and post-thoracotomy syndrome. Conclusions: In our opinion such hybrid VATS procedure has several advantages: starting with thoracoscopy it is possibleto exclude previously undetected pleural dissemination and to precisely define the tumor location as well as limits of the thoracic wall resection; time could be spared maintaining the patients in the supine position for both surgical times; postoperative pain and post-thoracotomy syndrome could be minimized avoiding the use of any rib retractor.
KW - Anterior Pancoast
KW - Chest wall
KW - Lung cancer
KW - Transmanubrial approach
KW - VATS lobectomy
UR - http://www.scopus.com/inward/record.url?scp=84963527511&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84963527511&partnerID=8YFLogxK
U2 - 10.1186/s13019-016-0446-7
DO - 10.1186/s13019-016-0446-7
M3 - Article
VL - 11
JO - Journal of Cardiothoracic Surgery
JF - Journal of Cardiothoracic Surgery
SN - 1749-8090
IS - 1
M1 - 65
ER -