期刊
JOURNAL OF PEDIATRIC SURGERY
卷 56, 期 6, 页码 1237-1241出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2020.12.021
关键词
Median sternotomy; Superior sulcus tumors; Pediatrics
Pediatric tumors in the apex of the thoracic cavity are often diagnosed late due to the absence of symptoms. Surgical resection of these large tumors may involve an extended sternotomy with a lateral neck incision to achieve optimal exposure. Different techniques, including both anterior and posterior thoracic approaches, have been described, but may have limitations in exposing the mass adequately.
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). (c) 2021 Elsevier Inc. All rights reserved.
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