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 |
Keywords
- Anterior Pancoast
- Chest wall
- Lung cancer
- Transmanubrial approach
- VATS lobectomy
ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine