Extended Chamberlain minithoracotomy: a safe and versatile approach for difficult lung resections

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Pulmonary Resection

Background:

• Traditional surgical approaches for pulmonary resection include hemi-clamshell sternotomy and extended lateral thoracotomy.
• These methods can lead to significant incisional morbidity and muscle dysfunction.

Purpose of the Study:

• To evaluate the perioperative outcomes of the anterior "extended Chamberlain" minithoracotomy.
• To assess its safety and efficacy as an alternative for pulmonary hilum access and anatomic pulmonary resection.

Main Methods:

• Retrospective review of 162 patients undergoing anatomic lung resection via mini anterior thoracotomy (2002-2010).
• An 8-cm anterior thoracotomy was performed in the supine position, splitting the second intercostal space.
• Key outcomes included hospital course, complications, and mortality.

Main Results:

• Successful resection in 99% of patients; 1 conversion to hemi-clamshell for vascular control.
• Complication rate was 29.6%, with a 1.9% perioperative mortality rate.
• Median length of hospital stay was 8 days.

Conclusions:

• The "extended Chamberlain" approach provides direct, less-invasive access to the pulmonary hilum.
• This technique preserves muscle function and avoids the morbidity associated with sternotomy or extended lateral thoracotomy.