Superior mediastinal tumour excision through upper partial sternotomy and chamberlain incision
Keywords:Superior mediastinal tumour, Chamberlain incision, Partial sternotomy
Superior mediastinal mass excision can be performed by various approaches such as partial sternotomy, mini trapdoor incision, anterior cervical transsternal approach and lateral thoracotomies. However, adequate exposure especially of superior surface seems to be difficult. Total four patients of superior mediastinal mass were admitted in the department of cardiothoracic and vascular surgery, Safdarjung hospital, New Delhi between June 2019 to May 2021. All of them were operated by upper partial sternotomy with right or left chamberlain extension of incision. It is safe and effective in terms of exposure with early recovery as well as cosmesis. Hence, we advocate the use of upper partial sternotomy with left or right chamberlain incision which provides good exposure in addition to ease of patient position, vascular control and emergency institution of cardiopulmonary bypass.
Ladas G, Peter H, Rhys-Evans PH, Gold-straw P. Anterior cervical trans sternal approach for resection of benign tumours at the thoracic inlet. Ann Thorac Surg. 1999;67(1):785-9.
Cohn LH. Minimally invasive valve surgery. J Card Surg. 2001;16:260-5.
Orringer MB. Partial median sternotomy: anterior approach to the upper thoracic esophagus. J Thorac Cardiovasc Surg. 1984;87(1):124-9.
Grillo HC. Surgical approaches to the trachea. Surg Gynecol Obstet. 1969;129(2):347-52.
Shields T. Primary lesions of the mediastinum and their investigation and treatment. In: Shields TW, ed. General thoracic surgery. Philadelphia: Williams and Wilkins. 1994;1724-69.
Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 2010;32(6):1325-39.
Eren S, Karaman A, Okur A. The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT. Eur J Radiol. 2006;59(1):93-103.
Li WWL, Van Boven WJP, Annema JT, Eberl S, Klomp HM, De Mol BAJM. Management of large mediastinal masses: surgical and anesthesiological considerations. J Thorac Dis. 2016;8(3):E175-84.
Paul S, Lee PC, Altorki NK, Stiles BM, Port JL. Partial upper sternotomy for anterosuperior mediastinal surgery: An institutional experience. Ann Surg Oncol. 2009;16(4):1039-42.
Shpitzer T, Saute M, Gilat H, Raveh E, Koren I, Shvero J et al. Adaptation of median partial sternotomy in head and neck surgery. Am Surg. 2007;73:1275-8.
Alifano M, Forti Parri SN, Arab WA, Bonfanti B, Lacava N, Porrello C et al. Limited upper sternotomy in general thoracic surgery. Surg Today. 2008;38(4):300-4.
Shrager JB, Deeb ME, Mick R, Brinster CJ, Childers HE, Marshall MB et al. Transcervical thymectomy for myasthenia gravis achieves results comparable to thymectomy by sternotomy. Ann Thorac Surg. 2002;74(2):320-6.
Bodner J, Wykypiel H, Greiner A, Kirchmayr W, Freund MC, Margreiter R et al. Early experience with robot-assisted surgery for mediastinal masses. Ann Thorac Surg. 2004;78(1):259-65.
Deeb ME, Brinster CJ, Kucharzuk J, Shrager JB, Kaiser LR. Expanded indications for transcervical thymectomy in the management of anterior mediastinal masses. Ann Thorac Surg. 2001;72(1):208-11.
Kido T, Hazama K, Inoue Y, Tanaka Y, Takao T. Resection of anterior mediastinal masses through an infrasternal approach. Ann Thorac Surg. 1999;67:263-5.