Thorac Cardiovasc Surg 2004; 52(4): 200-205
DOI: 10.1055/s-2004-820901
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Hemi-Clamshell Approach for Advanced Primary Lung Cancer

M. Ohta1 , H. Hirabayasi1 , H. Shiono1 , M. Minami1 , H. Maeda2 , N. Sawabata2 , G. Matsumiya1 , S. Miyoshi1 , H. Matsuda1
  • 1Department of General Thoracic Surgery, Osaka University, Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
  • 2Department of General Thoracic Surgery, Toneyama National Hospital, Osaka, Japan
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Publication History

Received October 20, 2003

Publication Date:
04 August 2004 (online)

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Abstract

Background: The hemi-clamshell approach provides a wide anterior view of the mediastinum, apical dome, and cervicothoracic area. However, only a few reports have been made regarding this technique. Methods: The hemi-clamshell approach was used in 24 patients, of whom 5 had a Pancoast tumor, 15 had mediastinal involvement, and 4 underwent mediastinal lymphadenopathy for left-sided lung cancer. Twenty-one of the patients received preoperative therapy. Results: Twenty-one operations were complete resections. In addition, 12 patients received cardio-vascular reconstruction and 5 a first rib resection. Postoperative major morbidity was 21 % (6/24) and mortality was 4.2 % (1/24). Nine patients died of systemic tumor relapse and 14 patients were alive after a median follow-up of 24 months (range 3 - 68 months) following the initial therapy. The 5-year survival rate of patients with mediastinal involvement was 37 % and that of 13 patients with postoperative stage I or II was 35 %. Conclusions: The hemi-clamshell approach provides a wide exposure allowing a safe and complete removal of lung cancer that involves the mediastinum and apical thoracic dome, leading to a better long-term survival rate for patients with this disease.

References

Mitsunori Ohta

Department of General Thoracic Surgery
Osaka University Graduate School of Medicine, E1

2 - 2 Yamadaoka, Suita

Osaka, 565-0871

Japan

Phone: + 8168793152

Fax: 81 68 79 31 64

Email: ohta@surg1.med.osaka-u.ac.jp