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Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
[Approach by clamshell incision for bilateral pulmonary metastasis]
Mitsuteru Yoshida1, S Sakiyama, K Kenzaki
1Department of Oncological and Regenerative Surgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 8, 2008
Summary
The clamshell incision provides excellent bilateral lung access for pulmonary metastasectomy, enabling complete resection of multiple lesions. This approach is recommended for patients requiring multiple procedures due to potential reoperation access.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
Background:
- The clamshell incision is increasingly utilized for complex thoracic procedures requiring bilateral lung access.
- Indications include heart-lung transplantation, bilateral lung tumors, and mediastinal tumors involving the lung.
Observation:
- Four patients underwent bilateral thoracotomy using a clamshell incision for pulmonary metastasectomy between 2001 and 2005.
- All patients presented with bilateral pulmonary metastases requiring multiple wedge resections.
Findings:
- The clamshell incision facilitated complete resection of all preoperatively identified lesions.
- This surgical approach allows for wedge resection anywhere in the lung, particularly useful for bilateral pulmonary metastases not requiring lobectomy.
Implications:
- The clamshell incision is a valuable surgical approach for bilateral pulmonary metastasectomy, offering wide visibility and access.
- It is particularly recommended for cases with expected multiple procedures, as it preserves an alternative route for reoperation.
