Thoracoabdominal incisions and resection of upper retroperitoneal sarcomas.

BACKGROUND AND OBJECTIVES

There is a widespread impression among surgeons that a thoracoabdominal incision carries a substantially higher risk of morbidity and possible mortality over abdominal incisions. We decided therefore to critically review our experience of the last 4 years with these incisions.

METHODS

This is a retrospective review of all cases of retroperitoneal sarcomas of upper abdominal quadrants in the period May 1995 through February 1999. There were 33 consecutive patients and 34 thoracoabdominal incisions (1 patient had a second operation for recurrence). Their mean age was 54 years, with 13 >60 and 7 >70 years.

RESULTS

Eighteen patients were extubated immediately at the end of the procedure and the rest within 24 h. In the majority of instances (32 of 34 or 94%), the patients left the intensive care unit within 48 h. The most common postoperative complication was atelectasis (7 of 34, 21%). There was no postoperative death. The retroperitoneal tumor was resected in all 34 cases (100%).

CONCLUSIONS

The thoracoabdominal incision for upper quadrant retroperitoneal sarcomas is tolerated well by the patients with a morbidity similar to that observed after routine abdominal incisions. It allows complete resection of the tumor in most (all in this series) cases.