2004
DOI: 10.1055/s-2004-820901 View full text |Buy / Rent full text
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Abstract: 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.

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“…Although tumors with invasion to large vessels of the mediastinum can be resected via a median approach, HCS was needed in this case to resect the mediastinal tumor showing hilar invasion. In general, the operative procedure used in the present cases was based on our previous report regarding an HCS approach for advanced primary lung cancer (6,7). The patient is placed in a semi-lateral decubitus position and secured firmly to the surgical bed to allow for rotation.…”
Section: Representative Casementioning
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“…Although tumors with invasion to large vessels of the mediastinum can be resected via a median approach, HCS was needed in this case to resect the mediastinal tumor showing hilar invasion. In general, the operative procedure used in the present cases was based on our previous report regarding an HCS approach for advanced primary lung cancer (6,7). The patient is placed in a semi-lateral decubitus position and secured firmly to the surgical bed to allow for rotation.…”
Section: Representative Casementioning
“…Therefore, for such lung cancers, a hemiclamshell surgical approach consisting of a partial median sternotomy and anterolateral thoracotomy was generally adopted (6), providing an anterior view of the mediastinum and exposure of the apex of the chest (7). However, the hemi-clamshell approach also has several disadvantages, such as insufficient exposure of the posterior mediastinum and causing rib fracture (7,8). Therefore, in order to achieve a radical resection of locally advanced lung cancers invading both right upper lung and SVC, we introduced a twostep surgical approach combining median sternotomy and subsequent posterolateral thoracotomy.…”
Section: However For Certain Patients Radical Resection Couldmentioning
“…11,12 Another clavicular-sparing approach is the hemi-clamshell incision. 13 The hemi-clamshell incision is used with the patient in the full lateral position with slight posterior rotation. The ipsilateral arm is abducted 90 o and secured with an arm support on the posterior table rail.…”
Section: Operative Techniquementioning
“…An alternative approach involves bisecting the manubrium to preserve the claviculomanubrial junction 11,12. Another clavicular-sparing approach is the hemi-clamshell incision 13. The hemi-clamshell incision is used with the patient in the full lateral position with slight posterior rotation.…”
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