1995
DOI: 10.1055/s-2007-1013210 View full text |Buy / Rent full text
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Abstract: Thirteen patients with malignancies which had invaded the subclavian vessels and/or distal border of the innominate vessels were operated on through modified "trap-door" thoracotomy. The modification is the additional resection of the first rib from inside the thorax. Tumors consisted of thyroid cancer in 5 patients, thymic tumor in 3, Pancoast tumor in 3, and lymphoma in 2. Invaded vessels were on the left side in 9 cases, on the right in 3, and bilateral in one. Subclavian and/or innominate veins were resect… Show more

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“…The hemiclamshell incision offers a good alternative in this situation and it can be extended into the neck to become the trap door thoracotomy described by Nazzaro [18]. The visualization of the thoracic inlet can be further improved by transection of the ®rst rib at its medial end [19]. In addition, this incision can be helpful to reach the anterior aspect of the cervico-thoracic spine (C4-T3) [ 20± 22].…”
Section: Discussionmentioning
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“…The hemiclamshell incision offers a good alternative in this situation and it can be extended into the neck to become the trap door thoracotomy described by Nazzaro [18]. The visualization of the thoracic inlet can be further improved by transection of the ®rst rib at its medial end [19]. In addition, this incision can be helpful to reach the anterior aspect of the cervico-thoracic spine (C4-T3) [ 20± 22].…”
Section: Discussionmentioning
“…6 If the subclavian vein is involved, the costoclavicular space needs to be opened as described in zone 1, with resection of the first rib or clavicle. 15,[17][18][19] Tumors located in zone 3 are accessed by a vertical cervicotomy along the anterior border of the sternocleidomastoid muscle extending into the upper part of the sternum. The sternocleiodmastoid muscle is then reflected laterally by splitting the upper part of the sternum down to the first intercostal space (cervical-transsternal approach) or below (hemiclamshell approach).…”
Section: Surgical Approachmentioning