Surgical resection for advanced lung cancer using the hemi-clamshell approach

Interactive Cardiovascular and Thoracic Surgery
Yasushi ShintaniMitsunori Ohta

Abstract

The hemi-clamshell (HCS) approach consists of partial sternotomy with antero-lateral thoracotomy. This study evaluated the utilities and outcomes of the HCS approach in advanced lung cancer patients. We retrospectively investigated 45 patients who underwent surgery for advanced lung cancer via the HCS procedure between 2000 and 2014, the indications for surgery being tumour invasion extending to the aorta arch in 5, descending aorta in 9, main pulmonary artery in 5, superior vena cava in 6, right or left atrium in 4, apical thoracic dome in 7 patients and mediastinal lymphadenopathy for left-sided lung cancer in 12. Preoperative chemo-radiation induction therapy was given to 33 of these patients. We performed 34 lobectomies, including 8 sleeve lobectomies, 10 pneumonectomies and 1 wedge resection of the lung. Cardiovascular reconstruction of the aortic arch was performed in 3, descending aorta in 4, subclavian arteries in 4, superior vena cava in 5, atrial wall in 4 and pulmonary artery in 12 patients with some overlap. En bloc chest wall resection was performed in 7 patients. Lymphadenectomy in the pre-tracheal and subcarinal areas was routinely performed. Forty-two operations (93%) were complete resections. No postoperative m...Continue Reading

References

Feb 25, 1998·The Journal of Thoracic and Cardiovascular Surgery·R J Korst, M E Burt
Jan 27, 1999·The Journal of Thoracic and Cardiovascular Surgery·E A RendinaC Ricci
Sep 15, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·D LardinoisH B Ris
Aug 5, 2004·The Thoracic and Cardiovascular Surgeon·M OhtaH Matsuda
Sep 24, 2009·Interactive Cardiovascular and Thoracic Surgery·Guillaume LebretonJacques Jougon
May 26, 2011·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Inderpal S SarkariaValerie W Rusch
Sep 14, 2016·Journal of Thoracic Disease·Weigang Zhao, Wentao Fang

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Citations

Nov 13, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sara MantovaniPascal Alexandre Thomas
Aug 29, 2019·Technology in Cancer Research & Treatment·Ryu KanzakiMeinoshin Okumura

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