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Modified technique for radical transmediastinal forequarter amputation and chest wall resection
The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1978
Summary
Forequarter amputation, a major surgery for shoulder girdle cancers and trauma, can be improved with a modified transmediastinal approach. This technique offers better exposure and reduced blood loss for radical chest wall resection.
Area of Science:
- Surgical Oncology
- Thoracic Surgery
Background:
- Forequarter amputation is indicated for malignant lesions, extensive trauma, or palliative care of the shoulder girdle.
- Established techniques include Berger, anterior pectoral, and posterior retroscapular approaches, with transthoracic approaches for chest wall invasion.
Observation:
- This report details a modified radical forequarter amputation and chest wall resection using a transmediastinal approach.
- The technique was applied to two patients with advanced axillary tumors involving the chest wall.
Findings:
- The transmediastinal approach facilitates early ligation of subclavian and internal mammary vessels, minimizing blood loss.
- It provides safe, excellent exposure for dividing major vessels and early exploration of mediastinal/intrathoracic structures.
- This method avoids extensive rib resection, streamlining the procedure.
Implications:
- This modified technique offers an effective alternative for complex forequarter amputations with chest wall resection.
- It potentially improves surgical outcomes by enhancing safety and efficiency.
- The approach is valuable for managing challenging oncological and traumatic cases in the shoulder girdle and chest wall.