Duranti Leonardo, Tavecchio Luca
Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian1, 20133, Milan, Italy.
Updates Surg. 2025 Apr;77(2):541-547. doi: 10.1007/s13304-024-02027-7. Epub 2024 Oct 25.
The transmanubrial osteomuscular sparing approach (TMA) is recommended for surgeries involving or originating from the thoracic outlet structures. We present a series of consecutive patients treated from 2014 to 2024 who underwent oncological thoracic outlet surgery for primary or metastatic (non-pulmonary) malignancies. Overall, 33 patients were included. Our procedures resulted in no mortality, seven complications (21.2%) and all surgeries achieved radical (R0) status. In the hands of experienced professionals, the TMA approach proves to be safe and conservative, enabling radical surgery for tumors of the thoracic outlet. For low-grade tumors, it avoids the need for additional combined surgical access, while for high-grade tumors, it allows for more extensive en bloc resection.
经胸骨旁保留肌肉骨骼入路（TMA）推荐用于涉及胸出口结构或起源于胸出口结构的手术。我们展示了一系列在2014年至2024年期间接受治疗的连续患者，他们因原发性或转移性（非肺部）恶性肿瘤接受了胸出口肿瘤手术。总体而言，共纳入33例患者。我们的手术无死亡病例，7例并发症（21.2%），所有手术均达到根治性（R0）状态。在经验丰富的专业人员手中，TMA入路被证明是安全且保守的，能够对胸出口肿瘤进行根治性手术。对于低级别肿瘤，它避免了额外联合手术入路的需要，而对于高级别肿瘤，它允许进行更广泛的整块切除。
