[Thoracotomy Approach to Large Tumors]

Surgery for large tumors that occupy one side of the thoracic cavity requires a surgical strategy that considers not only the localization and size of the tumor but also tumor manipulation, access to adjacent vital organs such as the pulmonary arteriovenous, the tumor infiltration range, and combined organ resection. To perform safe and high-quality surgery, it is necessary to obtain a good surgical field, and determining the optimal surgical approach to use is also important. Thoracotomies include posterolateral thoracotomy, rib-cross thoracotomy, clamshell thoracotomy, hemi-clamshell thoracotomy, and transmanubrial osteomascular-sparing approach. Anatomical proficiency, preoperative imaging evaluation, thoracotomy simulations, and meetings with anesthesiologists are also important.