Résumé
Mediastinal tumors consist of wide spectrum of benign and malignant disease. Some of these tumors which locate in the thoracic apex can produce many problems in decision making due to developing to neck spaces. With thoracotomy approach most of these tumors cannot be resected totally because of close attachment of these tumors to great vessels and removal of these tumors accompanied with dangerous complications and massive hemorrhages during surgery. The goal of this study is to report the operated cases of these kinds of tumors with anterior trans cervical-thoracic approach. Depending on the tumor extension in neck spaces, first with on oblique incision near the SCM [Sternoclidomastoeid] muscle neck space dissection is done, In all patients the clavicle head is resected to see the subclavian vessels, then with continuing the incision, as in partial sternotomy, the mediastinal space is being assessed for complete removal of tumor. If needed, for complete removal of mediastinal tumor, the operation is completed with an anterior thoracotomy. There were 3 patients in our study; all were females; with age between 10 to 21 years old. Pathology reports of them were: one case ganglioneuroblastoma, one case neurofibroma and the other, medullary carcinoma of thyroid. Tumor extension in neck spaces in 2 patients was at the left side and in one patient in right side. In all three patients tumors were completely removed by mentioned technique and only in one case an anterior thoracotomy was needed to remove the huge mediastinal tumor. Total resection of tumors were done in all 3 patients and there were no severe injuries to great vessels and all patients were discharged from hospital without any complications and are being observed for 6 months until now without tumor recurrence. The median time for hospitalization was 5.5 days. Due to good exposure of neck and mediastinal great vessels and succeed in removing these tumors, we advise using this technique for approaching them. Of course it is obvious that more studies are needed in future