Anterior Trans Cervicothoracic Approach for Complete Resection of Cervicothoracic Mediastinal Neurogenic Tumors
Publish place: Journal of Cardio-Thoracic Medicine، Vol: 1، Issue: 3
Publish Year: 1392
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_JCTM-1-3_003
تاریخ نمایه سازی: 4 آذر 1398
Abstract:
Introduction:Neurogenic mediastinal tumors comprise a wide range of benign and malignant diseases. A group of these tumors, located at thoracic apex, sometimes spread to cervical spaces causing numerous surgical difficulties. In thoracotomy approaches, due to proximity of the tumors to major blood vessels, complete removal of these tumors from cervical spaces is impossible or may cause intraoperative severe bleeding or other dangerous incidents Because of the adjacent major vessels that are not visible.The aim of this study is to report cases of surgical treatment of such tumors using Anterior Trans Cervicothoracic Approach (ATCA). Materials and Methods:All patients with neurogenic tumors and cervicomediastinal (CM) spread who underwent surgey with ATCA technique during 2005-2011 were included in our study. Then they were evaluated in terms of age, sex, clinical symptoms, radiological and pathological findings, technical success rate of the surgery, surgical complications and first-year relapse rate after the surgery. Results:Our study included 10 patients from whom 9 were female and 1 was male (M/F= 1/9) and the mean age was 27 years. The most common symptoms were pain and feeling of a lump. All patients were operated by this technique successfully. The most common pathological finding was neurofibroma (in 5 patients) and surgical complications occurred in 2 patients (20%) (Wound infection in 1 patient and brachial plexus injury in another patient). There was no mortality. Disease relapse was reported in 1 patient ganglioneuroblastoma who underwent surgical resection for the second time. Conclusion: Considering the successful removal of the tumors and favorable exposure of major vessels in cervicomediastinal spaces, this technique is recommended to resect mediastinal tumors with spread to cervical spaces. However, a more definite conclusion requires further studies.
Authors
Reza Bagheri
Toracic Surgeon,Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Taghi Rajabi Mashadi
General Surgeon,Minimally Invasive and Endoscopic Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Hossein Mashhadi Nejad
Neurosurgeon,Mashhad University of Medical Sciences, Mashhad, Iran
Shima Sheibani
General Practitioner, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran