Transmanubrial osteomuscular sparing approach: different indications

Interactive Cardiovascular and Thoracic Surgery
Gaetano Di RienzoAnna Lucia Urgese

Abstract

The surgery of the cervico-thoracic inlet is a challenge for the thoracic surgeon. Several authors have described different approaches - with different degrees of invasiveness - to this anatomical area. We used the transmanubrial osteomuscular sparing approach described by Grünenwald and Spaggiari for six patients with five different indications: 1) left anterior Pancoast tumor; 2) glomus tumor originating from the inferior trunk (C8-T1 roots) of the right brachial plexus; 3) T1 vertebral tumor; 4) right internal jugular chain, Pirogoff confluence and subclavian artery metastatic lymph nodes from thyroid carcinoma; 5) chondrosarcoma of the first left rib. The results have been satisfactory from a surgical point of view, considering that the approach gave a good exposure of the operative field (especially at the cervical level), without cosmetic problems or functional limitations. In our experience, the transmanubrial osteomuscular sparing approach is a valid technique for the treatment of several kinds of tumors of the cervico-thoracic inlet, giving a good exposure of the operative field. In the case of anterior Pancoast tumors, the upper lobectomy may necessitate a further axillary thoracotomy, when fissural adherences are pre...Continue Reading

References

Mar 1, 1993·The Annals of Thoracic Surgery·P MacchiariniF Parquin
Feb 1, 1997·The Annals of Thoracic Surgery·D Grunenwald, L Spaggiari
Aug 4, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·T Vanakesa, P Goldstraw
Dec 28, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·L SpaggiariU Pastorino
Sep 24, 2004·Thoracic Surgery Clinics·Paolo Macchiarini
Sep 4, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Gaetano Di RienzoAnna Lucia Urgese

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Citations

Sep 9, 2016·Journal of Surgical Case Reports·Tomohiro HarukiHiroshige Nakamura
Apr 15, 2017·Pediatric Blood & Cancer·Aziz El MadiSabine Sarnacki
Feb 6, 2020·Current Opinion in Otolaryngology & Head and Neck Surgery·Cesare PiazzaLorenzo Giannini

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