The transclavicular approach improved the treatment of apical chest tumors. However, removing the internal half of the clavicle and sectioning its muscular insertions led to serious postoperative alterations. We propose a transmanubrial approach, through a manubrial L-shaped transection and first costal cartilage resection, which allows retraction of an osteomuscular flap including but sparing the clavicle and all its muscular insertions. The elevation of the osteomuscular flap affords excellent access to the subclavicular region with safe control and resection of neurovascular outlet structures during the resection of apical chest tumors. Shoulder articulations and stability of the scapular girdle are respected, thus avoiding functional and cosmetic consequences of clavicle resection.

Transmanubrial osteomuscular sparing approach for apical chest tumors / D. Grunenwald, L. Spaggiari. - In: ANNALS OF THORACIC SURGERY. - ISSN 0003-4975. - 63:2(1997 Feb), pp. 563-6-566. [10.1016/S0003-4975(96)01023-5]

Transmanubrial osteomuscular sparing approach for apical chest tumors

L. Spaggiari
Ultimo
1997

Abstract

The transclavicular approach improved the treatment of apical chest tumors. However, removing the internal half of the clavicle and sectioning its muscular insertions led to serious postoperative alterations. We propose a transmanubrial approach, through a manubrial L-shaped transection and first costal cartilage resection, which allows retraction of an osteomuscular flap including but sparing the clavicle and all its muscular insertions. The elevation of the osteomuscular flap affords excellent access to the subclavicular region with safe control and resection of neurovascular outlet structures during the resection of apical chest tumors. Shoulder articulations and stability of the scapular girdle are respected, thus avoiding functional and cosmetic consequences of clavicle resection.
Thoracic Neoplasms; Manubrium; Humans; Thoracic Surgery; Surgical Flaps
Settore MED/21 - Chirurgia Toracica
feb-1997
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/181275
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