Spaggiari L, Calabrese L, Gioacchino G, Pastorino U
Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy.
Eur J Cardiothorac Surg. 1999 Nov;16(5):564-7. doi: 10.1016/s1010-7940(99)00311-5.
Twelve patients with cervico-thoracic tumors underwent transmanubrial approach during a 1-year period. All but two patients with NSCLC (n = 8), had double approaches. Three cases with cervical esophageal cancer underwent TMA and laparotomy. The last patient underwent TMA for cervical fibrosarcoma. One patient underwent subclavian artery resection, while another one resection of the left brachicephalic vein with graft replacement. Two cases, in the esophageal cancer group, had laryngeal nerve palsy requiring temporary tracheostomy. TMA affords an excellent exposure of the thoracic in/outlet allowing extended resection. Sparing the main osteo-muscular structures, it respects shoulder mobility of the scapular girdle, thus avoiding deformities due to clavicle resection.
在1年的时间里,12例患有颈胸段肿瘤的患者接受了经胸骨柄入路手术。除了2例非小细胞肺癌患者(n = 8)外,所有患者都采用了联合入路。3例颈椎食管癌患者接受了经胸骨柄入路手术和剖腹手术。最后1例患者因颈椎纤维肉瘤接受了经胸骨柄入路手术。1例患者接受了锁骨下动脉切除术,另1例患者接受了左头臂静脉切除并进行了血管移植置换。在食管癌组中,有2例患者出现喉返神经麻痹,需要进行临时气管切开术。经胸骨柄入路能够很好地暴露胸段的出入部位,从而实现扩大切除。该入路保留了主要的骨肌结构,保留了肩胛带的肩部活动度,从而避免了因锁骨切除导致的畸形。