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Hemi-clamshell approach for advanced primary lung cancer.
M Ohta1, H Hirabayasi, H Shiono
1Department of General Thoracic Surgery, Osaka University, Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan. ohta@surg1.med.osaka-u.ac.jp
The Thoracic and Cardiovascular Surgeon
|August 5, 2004
Summary
The hemi-clamshell approach offers wide surgical exposure for lung cancer involving the mediastinum and apical dome. This technique facilitates complete tumor removal, potentially improving long-term survival rates for patients.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
Background:
- The hemi-clamshell approach provides extensive anterior visualization of the mediastinum, apical dome, and cervicothoracic region.
- Limited published reports exist on the application and outcomes of this surgical technique.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the hemi-clamshell approach in patients with advanced lung cancer involving the mediastinum and apical thoracic dome.
Main Methods:
- The hemi-clamshell approach was utilized in 24 patients undergoing surgery for lung cancer.
- Patient conditions included Pancoast tumors (5), mediastinal involvement (15), and mediastinal lymphadenopathy (4).
- Twenty-one patients received preoperative therapy prior to surgical intervention.
Main Results:
- Complete resection was achieved in 21 operations.
- Postoperative major morbidity was 21% and mortality was 4.2%.
- The 5-year survival rate for patients with mediastinal involvement was 37%, and for those with postoperative stage I or II disease was 35%.
Conclusions:
- The hemi-clamshell approach enables wide surgical exposure for safe and complete resection of lung cancers involving the mediastinum and apical thoracic dome.
- This technique may contribute to improved long-term survival outcomes for patients with these challenging lung cancer presentations.