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DOI: 10.1055/s-2004-820901
© Georg Thieme Verlag KG Stuttgart · New York
Hemi-Clamshell Approach for Advanced Primary Lung Cancer
Publikationsverlauf
Received October 20, 2003
Publikationsdatum:
04. August 2004 (online)
![](https://www.thieme-connect.de/media/thoracic/200404/lookinside/thumbnails/10.1055-s-2004-820901-1.jpg)
Abstract
Background: The hemi-clamshell approach provides a wide anterior view of the mediastinum, apical dome, and cervicothoracic area. However, only a few reports have been made regarding this technique. Methods: The hemi-clamshell approach was used in 24 patients, of whom 5 had a Pancoast tumor, 15 had mediastinal involvement, and 4 underwent mediastinal lymphadenopathy for left-sided lung cancer. Twenty-one of the patients received preoperative therapy. Results: Twenty-one operations were complete resections. In addition, 12 patients received cardio-vascular reconstruction and 5 a first rib resection. Postoperative major morbidity was 21 % (6/24) and mortality was 4.2 % (1/24). Nine patients died of systemic tumor relapse and 14 patients were alive after a median follow-up of 24 months (range 3 - 68 months) following the initial therapy. The 5-year survival rate of patients with mediastinal involvement was 37 % and that of 13 patients with postoperative stage I or II was 35 %. Conclusions: The hemi-clamshell approach provides a wide exposure allowing a safe and complete removal of lung cancer that involves the mediastinum and apical thoracic dome, leading to a better long-term survival rate for patients with this disease.
Key words
Hemi-clamshell approach - lung cancer - mediastinal invasion
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Mitsunori Ohta
Department of General Thoracic Surgery
Osaka University Graduate School of Medicine, E1
2 - 2 Yamadaoka, Suita
Osaka, 565-0871
Japan
Telefon: + 8168793152
Fax: 81 68 79 31 64
eMail: ohta@surg1.med.osaka-u.ac.jp