Xu Yanzhao, Qi Junhao, Zhang Yuefeng, Wen Shiwang, Li Zhenhua, Wang Mingbo, Su Peng, Huang Chao, Zhang Fan, Tian Ziqiang
Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, Hebei, 050017, People's Republic of China.
World J Surg Oncol. 2025 Sep 26;23(1):346. doi: 10.1186/s12957-025-03987-9.
To evaluate the clinical efficacy of Grunenwald incision in cervicothoracic junction surgery.
A retrospective analysis was performed on 29 patients treated at the Fourth Hospital of Hebei Medical University, including 28 patients with cervicothoracic junction tumors (11cases of upper mediastinal tumors, 7 cases of superior sulcus tumors, 4 cases of thyroid tumors with upper mediastinal invasion, 4 cases of chest wall tumors, 2 cases of esophageal cancers with supraclavicular lymph node metastasis) and 1 patient with cervicothoracic junction penetrating trauma. Grunenwald incision or additional posterolateral thoracic incision, median sternal incision or neck collar incision were used in all patients.
There was no perioperative death in the whole group. Complete tumor resection was achieved in 25 cases; palliative resection was performed in three cases, and one case underwent complete foreign body removal. The operation time ranged from 120 to 430 minutes, with an average of (231.90 ± 85.30) minutes. The intraoperative blood loss was between 100 and 1000 milliliters, with an average of (286.56 ± 192.90) milliliters. The postoperative hospital stay lasted 6 to 28 days, with an average of (13.14 ± 5.12) days. Follow-up periods spanned 6 to 142 months, with an average of (66.66 ± 46.96) months. During the follow-up period, six patients died.
Grunenwald incision can provide good exposure of the structures near the cervicothoracic junction, preserve the integrity of the sternoclavicular joint, reduce shoulder deformity, and has advantages for patients with cervicothoracic junction tumor, high rib resection, and cervicothoracic junction trauma.
评估格鲁嫩瓦尔德切口在颈胸交界区手术中的临床疗效。
对河北医科大学第四医院收治的29例患者进行回顾性分析，其中包括28例颈胸交界区肿瘤患者（11例上纵隔肿瘤、7例肺尖部肿瘤、4例侵犯上纵隔的甲状腺肿瘤、4例胸壁肿瘤、2例伴有锁骨上淋巴结转移的食管癌）和1例颈胸交界区穿透伤患者。所有患者均采用格鲁嫩瓦尔德切口或附加后外侧开胸切口、正中胸骨切口或颈部领式切口。
全组无围手术期死亡。25例实现肿瘤完整切除；3例行姑息性切除，1例实现异物完全清除。手术时间为120至430分钟，平均（231.90±85.30）分钟。术中出血量为100至1000毫升，平均（286.56±192.90）毫升。术后住院时间为6至28天，平均（13.14±5.12）天。随访时间为6至142个月，平均（66.66±46.96）个月。随访期间，6例患者死亡。
格鲁嫩瓦尔德切口能良好暴露颈胸交界区附近结构，保留胸锁关节完整性，减少肩部畸形，对颈胸交界区肿瘤、高位肋骨切除及颈胸交界区创伤患者具有优势。
