Kameyama Kotaro, Huang Cheng-long, Hayashi Eiichi, Yokomise Hiroyasu
Second Department of Surgery, Kagawa Medical University, 1750-1, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Interact Cardiovasc Thorac Surg. 2004 Mar;3(1):201-3. doi: 10.1016/j.icvts.2003.11.001.
Extrapleural pneumonectomy is an essential procedure in multimodality therapy of malignant pleural mesothelioma. However, radical resection may be difficult in a standard posterolateral thoracotomy because the edge of the diaphragm is located in the dead angle of the pleural cavity. We have tried a subcostal thoracotomy following a posterolateral thoracotomy (extended posterolateral-subcostal thoracotomy) for extrapleural pneumonectomy. With extended posterolateral-subcostal thoracotomy, ideal surgical resection, with en bloc removal of the lung, parietal pleura, pericardium and diaphragm, can be performed radically, but safely, without a second thoracotomy. We conclude that extended posterolateral-subcostal thoracotomy is an effective approach for extrapleural pneumonectomy.
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