TY - JOUR
T1 - Extended sternotomy with lateral neck incision
T2 - An alternative approach for children with large apical chest masses with thoracic inlet involvement
AU - MacGregor, Robert M.
AU - Wilson, Nicole A.
AU - Shakhsheer, Baddr A.
AU - Keller, Martin S.
AU - Dillon, Patrick A.
AU - Abarbanell, Aaron M.
N1 - Publisher Copyright:
© 2021
PY - 2021/6
Y1 - 2021/6
N2 - Pediatric tumors in the apex of the thoracic cavity are often diagnosed late due to the absence of symptoms. These tumors can be quite large at presentation with involvement of the chest wall, sympathetic chain, spine, and aortic arch. The tumors can also extend into the thoracic inlet and encircle the brachial plexus. Depending on the diagnosis, treatment may involve chemotherapy with subsequent surgery or require primary resection. Optimal exposure to resect large apical tumors with thoracic inlet extension is a surgical challenge. To date, several surgical techniques have been described to resect these tumors – including both anterior and posterior thoracic approaches. Each of these techniques can be limited by inadequate exposure of the mass. We describe an alternative approach to surgical resection of these masses that employs an extended sternotomy with a lateral neck incision. This report details two successful resections of large left apical masses with thoracic inlet involvement in children using this technique (Level of evidence 4).
AB - Pediatric tumors in the apex of the thoracic cavity are often diagnosed late due to the absence of symptoms. These tumors can be quite large at presentation with involvement of the chest wall, sympathetic chain, spine, and aortic arch. The tumors can also extend into the thoracic inlet and encircle the brachial plexus. Depending on the diagnosis, treatment may involve chemotherapy with subsequent surgery or require primary resection. Optimal exposure to resect large apical tumors with thoracic inlet extension is a surgical challenge. To date, several surgical techniques have been described to resect these tumors – including both anterior and posterior thoracic approaches. Each of these techniques can be limited by inadequate exposure of the mass. We describe an alternative approach to surgical resection of these masses that employs an extended sternotomy with a lateral neck incision. This report details two successful resections of large left apical masses with thoracic inlet involvement in children using this technique (Level of evidence 4).
KW - Median sternotomy
KW - Pediatrics
KW - Superior sulcus tumors
UR - http://www.scopus.com/inward/record.url?scp=85099629095&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2020.12.021
DO - 10.1016/j.jpedsurg.2020.12.021
M3 - Article
C2 - 33485611
AN - SCOPUS:85099629095
SN - 0022-3468
VL - 56
SP - 1237
EP - 1241
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 6
ER -