Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches

Miyashita, Yudai; Fukui, Eriko; Ishida, Hiroto; Kimura, Toru; Kanou, Takashi; Ose, Naoko; Funaki, Soichiro; Shintani, Yasushi

doi:https://doi.org/10.1007/s00595-024-02838-6

Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches

Miyashita, Yudai; Fukui, Eriko; Ishida, Hiroto et al.

Surgery Today, 2024, 54(9), 1015-1021

Number of Access:1,063（2025-08-16 03:18 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/96464

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Title	Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches
Creator	CreatorName Miyashita, Yudai
	NRID 1000090814591 1000090814591 researchmap permalink ef90814591 ef90814591 Scopus Author ID 57205560883 57205560883 CreatorName Fukui, Eriko
	CreatorName Ishida, Hiroto
	NRID 1000090580796 1000090580796 ORCID 0000-0003-4504-232X 0000-0003-4504-232X researchmap permalink toru_kimura toru_kimura CreatorName Kimura, Toru
	NRID 1000070528455 1000070528455 researchmap permalink tkanou tkanou Scopus Author ID 55241221000 55241221000 CreatorName Kanou, Takashi
	NRID 1000010570559 1000010570559 researchmap permalink nose-1234 nose-1234 Scopus Author ID 24067435400 24067435400 CreatorName Ose, Naoko
	NRID 1000050464251 1000050464251 researchmap permalink so1 so1 Scopus Author ID 14123352700 14123352700 CreatorName Funaki, Soichiro
	NRID 1000090572983 1000090572983 researchmap permalink shintani6384 shintani6384 Scopus Author ID 7103142734 7103142734 CreatorName Shintani, Yasushi
Subject	Hemiclamshell approach
	Lung cancer
	Thymoma
	Transmanubrial osteomuscular sparing approach
Description	The version of record of this article, first published in Surgery Today, is available online at Publisher’s website: https://doi.org/10.1007/s00595-024-02838-6.
Abstract	Purpose: The hemiclamshell (HCS) approach provides a comprehensive view of the anterior mediastinum, whereas the transmanubrial osteomuscular sparing approach (TMA) allows sufficient exposure of the cervico-thoracic transition. We assessed the effectiveness and the outcomes of the combined HCS plus TMA approach to resect thoracic malignant tumors. Methods: We reviewed five patients with thoracic malignant tumors invading the thoracic outlet who underwent surgery using an HCS and TMA approach between 2018 and 2021. Results: The preoperative diagnosis was myxofibrosarcoma, lung cancer, thymic cancer, thymoma, and neurofibromatosis type1 in one patient each, respectively. Cardiovascular reconstruction was done on the aortic arch in two patients, on the descending aorta in one, and on the superior vena cava in one, combined with resection of the vagus nerve in three patients, of the phrenic nerve in two, and of vertebra in one, with overlap in some cases. The TMA was added because all patients required dissection of the periphery of the subclavian artery, and two had tumor extension to the neck. Macroscopic complete resection was achieved in four patients. There was no postoperative mortality. Conclusion: The combination of the HCS and TMA approaches at the same operation provides a comprehensive view of the mediastinum, lung, and cervico-thoracic transition and allows safe access to the thoracic great vessels and subclavian vessels.
Publisher	Springer
Source Title	Surgery Today
Volume (Issue)	54(9)
Page	1015-1021
Date of Issued	2024-05-06
Language	English
Handle URL	https://hdl.handle.net/11094/96464
PISSN	09411291
eISSN	14362813
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s00595-024-02838-6
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Surgery Today. 2024, 54(9), p. 1015-1021
DC.title	Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches
DC.creator	Miyashita, Yudai
	Fukui, Eriko
	Ishida, Hiroto
	Kimura, Toru
	Kanou, Takashi
	Ose, Naoko
	Funaki, Soichiro
	Shintani, Yasushi
DC.publisher	Springer
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-05-06
DC.identifier	https://doi.org/10.1007/s00595-024-02838-6
DC.subject	Hemiclamshell approach
	Lung cancer
	Thymoma
	Transmanubrial osteomuscular sparing approach
DC.description	The version of record of this article, first published in Surgery Today, is available online at Publisher’s website: https://doi.org/10.1007/s00595-024-02838-6.
DCTERMS.abstract	Purpose: The hemiclamshell (HCS) approach provides a comprehensive view of the anterior mediastinum, whereas the transmanubrial osteomuscular sparing approach (TMA) allows sufficient exposure of the cervico-thoracic transition. We assessed the effectiveness and the outcomes of the combined HCS plus TMA approach to resect thoracic malignant tumors. Methods: We reviewed five patients with thoracic malignant tumors invading the thoracic outlet who underwent surgery using an HCS and TMA approach between 2018 and 2021. Results: The preoperative diagnosis was myxofibrosarcoma, lung cancer, thymic cancer, thymoma, and neurofibromatosis type1 in one patient each, respectively. Cardiovascular reconstruction was done on the aortic arch in two patients, on the descending aorta in one, and on the superior vena cava in one, combined with resection of the vagus nerve in three patients, of the phrenic nerve in two, and of vertebra in one, with overlap in some cases. The TMA was added because all patients required dissection of the periphery of the subclavian artery, and two had tumor extension to the neck. Macroscopic complete resection was achieved in four patients. There was no postoperative mortality. Conclusion: The combination of the HCS and TMA approaches at the same operation provides a comprehensive view of the mediastinum, lung, and cervico-thoracic transition and allows safe access to the thoracic great vessels and subclavian vessels.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	96464
citation_title	Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches
citation_author	Miyashita, Yudai
	Fukui, Eriko
	Ishida, Hiroto
	Kimura, Toru
	Kanou, Takashi
	Ose, Naoko
	Funaki, Soichiro
	Shintani, Yasushi
citation_publisher	Springer
citation_language	English
citation_date	2024-05-06
citation_journal_title	Surgery Today
citation_volume	54
citation_issue	9
citation_firstpage	1015
citation_lastpage	1021
citation_doi	https://doi.org/10.1007/s00595-024-02838-6
citation_public_url	https://hdl.handle.net/11094/96464

Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches

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