[Anteroaxillary thoracotomy for curative surgery in lung cancer]

The method and results of anteroaxillary thoracotomy for curative surgery in lung cancer are reported. A 20 cm incision is made from the axilla past the nipple line. The serratus anterior muscle is divided, but the lattisimus dorsi muscle does not require division. For an upper lobectomy, the fourth intercostal space is divided, and for a lower lobectomy, the fifth intercostal space is divided. By spreading the thoracic opener, the anterior portion of the rib and costal cartilage are disconnected, and the thorax is opened sufficiently. In the posterior portion, the skin, including the lattisimus dorsi muscle is drawn posteriorly ising an "Octopus". By these techniques, the operative field is made large enough for lobectomy and lymph node dissection. Compared to posterolateral thoracotomy, chronic pain following surgery is dramatically reduced. By anteroaxillary thoracotomy we have satisfactorily performed lobectomy and lymph node dissection of 11 non-T 3 or T 4 lung cancers. In conclusion, anteroaxillary thoracotomy can be a useful approach for ordinal lobectomy and lymph node dissection in lung cancer.