Treatment of superior sulcus tumors using the improved antero-cervical parasternal approach / 中国医师进修杂志

ABSTRACT

ObjectiveTo investigate the experience of resection of superior sulcus tumors using the improved antero-cervical parastemal approach.MethodsThe clinical data of 3 patients with superior sulcus tumor from July 2005 to May 2010 were analyzed retrospectively.Three patients with superior sulcus tumor underwent en bloc resection using the improved antero-cervical parastemal approach.The 1st to 3rd rib were excised,1 case with 1/5 centrum vertebra excision,1 case with the 1st transverse process of thoracic vertebra excision,1 case with the 1 st and 2nd transverse process of thoracic vertebra excision,1 case with T1 nerve root and sellate ganglion excision.ResultsAll the patients recovered well after operation.There was no serious complication except for 1 case with secondary Horner syndrome.The mild paradoxicalbreathing was found in 3 cases postoperative dressing change,but they had no dyspnea and tolerance well.The paradoxical breathing was disappeared when the mediastinum was fixed after 14 d thoracic wall pressure dressing.The pathological diagnosis after operation:2 cases with squamous-celled carcinoma,1 case with adenosquamous carcinoma,there was no mediastinal lymph node metastasis,cutting edge was negative.Stage:2 cases with T3N0M0,1 case with T4N0M0.Three cases were treated with chemotherapy (NP plan) for 4 cycles after operation without radiotherapy.Three cases were followed up for 53,37, 13 months after operation,they were all survival without recurrence and good quality life.ConclusionsFor the treatment of especially anterior and middle seated superior sulcus tumors,improved antero-cervical parasternal approach provides a safe and effective exposure.The improved antero-cervical parasternal approach is worthy of promotion.