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2013, Number 1

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AMC 2013; 17 (1)

Lung resection and mediastinal dissection trough median sternotmy

García RME
Full text How to cite this article

Language: Spanish
References: 9
Page: 13-18
PDF size: 80.59 Kb.


Key words:

dissection, sternotomy, mediastinal neoplasms/surgery, surgical procedures, operative, lung neoplasms.

ABSTRACT

Introduction: in spite of the fact that anterolateral thoracotomy was the first approach as an attempt to conduct a pulmonary resection for pulmonary neoplasms, posterior and posterolateral approaches rapidly became a safe option. In the 50’s, posterolateral incision was the chosen option. Recently, specialists have started to use medial sternotomy, as well as Hemiclamshell's incision (longitudinal sternotomy with thoracic prolongation) and Clamshel's incision (transverse sternotomy) and they are carried out in particular circumstances. Objectives: introduce medial sternotomy for treating lung cancer. Method: the technique of medial sternotomy as an approach to conduct a pulmonary resection for cancer and the dissection of ganglial stations 1, 2, 3, 4, 5, 6, and 7, were described. Ebsco, Medline and Cochrane were consulted to obtain references. Conclusions: medial sternotomy is a safe and useful way to conduct pulmonary resection for cancer and mediastinal dissection, which also provides a more exact pathological classification than conventional thoracotomies, because it allows the approach to the superior, aortic, and subcarinal ganglial areas in a bilateral way as appropriate.


REFERENCES

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  2. Urschel HC. Median sternotomy for elective pulmonary surgery. In: Martini N, VogtMoykopf I, editors. Thoracic surgery frontiers and uncommon neoplasms. I ED. St. Louis: CV Mosby; 1989. p. 121.

  3. Sakao Y. The spread of metastatic lymph nodes to the mediastinum from left upper lobe cancer: results of superior mediastinal nodal dissection through a median sternotomy. Eur J Cardiothorac Surg. 2006;30:5437.

  4. Hirata TK. Koizumi. Changes in hemodynamics in patients who underwent extended mediastinal lymphadenectomy through median sternotomy for primary lung cancer. Jpn J Thorac Cardiovasc Surg. 2003;51(5):17885.

  5. Van Schil PE. From Individual Lymph Nodes to Stations and Zones East and West Reconciled? J Thoracic Oncol. 2009;4(5):2749.

  6. Asaph JW. Median sternotomy versus thoracotomy to resect primary lung cancer: analysis of 815 cases. Ann Thorac Surg. 2000;70:3739.

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  8. Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest. 1997;111:1718–23.

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AMC. 2013;17