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Eur J Cardiothorac Surg 1999;16:564-567
© 1999 Elsevier Science NL

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Cervico-thoracic tumors resection through transmanubrial osteomuscular sparing approach

^a Department of Thoracic Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
^b Department of Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy

Corresponding author. Tel.: +39-257-489-666; fax: +39-257-489-698
e-mail: lspaggia{at}ieo.it

Twelve patients with cervico-thoracic tumors underwent transmanubrial approach during a 1-year period. All but two patients with NSCLC (n=8), had double approaches. Three cases with cervical esophageal cancer underwent TMA and laparotomy. The last patient underwent TMA for cervical fibrosarcoma. One patient underwent subclavian artery resection, while another one resection of the left brachicephalic vein with graft replacement. Two cases, in the esophageal cancer group, had laryngeal nerve palsy requiring temporary tracheostomy. TMA affords an excellent exposure of the thoracic in/outlet allowing extended resection. Sparing the main osteo-muscular structures, it respects shoulder mobility of the scapular girdle, thus avoiding deformities due to clavicle resection.

Key Words: Transmanubrial approach • Apical chest tumors • Lung cancer • Bronchogenic carcinoma • Esophageal cancer • Pancoast tumor

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