Video-assisted pulmonary lobectomy combined with transmanubrial approach for anterior Pancoast tumor resection

Case report

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish
Article number65
JournalJournal of Cardiothoracic Surgery
Volume11
Issue number1
DOIs
Publication statusPublished - Apr 14 2016

Fingerprint

Pancoast Syndrome
Ribs
Video-Assisted Thoracic Surgery
Lung
Supine Position
Thoracotomy
Neoplasms
Thoracoscopy
Patient Rights
Thoracic Wall
Operative Time
Postoperative Pain
Veins
Length of Stay
Radiotherapy
Thorax

Keywords

  • Anterior Pancoast
  • Chest wall
  • Lung cancer
  • Transmanubrial approach
  • VATS lobectomy

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Video-assisted pulmonary lobectomy combined with transmanubrial approach for anterior Pancoast tumor resection: Case report",
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.",
keywords = "Anterior Pancoast, Chest wall, Lung cancer, Transmanubrial approach, VATS lobectomy",
author = "Lorenzo Rosso and Alessandro Palleschi and Paolo Mendogni and Mario Nosotti",
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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.

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KW - Lung cancer

KW - Transmanubrial approach

KW - VATS lobectomy

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