Thorac Cardiovasc Surg 2004; 52(1): 54-56
DOI: 10.1055/s-2004-815803
Original Thoracic

© Georg Thieme Verlag Stuttgart · New York

The Figure-L Unilateral Mini-Sternotomy for Anterior Mediastinal Tumor

S.-I. Watanabe 1 , S. Shimokawa 1 , K.-I. Sakasegawa 1 , Y. Nakamura 1 , K. Kariatsumari 1 , H. Oyama 1 , R. Sakata 1
  • 1Second Department of Surgery, Kagoshima University Faculty of Medicine, Kagoshima, Japan
Further Information

Publication History

Received May 19, 2003

Publication Date:
04 March 2004 (online)

Abstract

We performed a figure-L unilateral mini-sternotomy for anterior mediastinal tumor resection in ten patients. Pathological diagnosis among the ten included six thymomas, three mature teratomas including one with a seminoma component, and one thymic cyst. Mean tumor length was 7 × 5 × 4 cm. The required skin incision was 8 cm in mean length. The third intercostal space was transected in six cases, the fourth intercostal space in four cases. Bilateral internal thoracic arteries were preserved in all cases. All tumors were completely resected without complications during the procedure. Mean operating time was 106 minutes (range 85 to 120 minutes). Postoperative hospital stay ranged from three to seven days without any complications. All patients were alive at the end of a mean follow-up period of 39 months (range 3 to 60 months). The figure-L unilateral mini-sternotomy is considered an effective and useful minimally invasive approach for anterior mediastinal tumors.

References

  • 1 Shields T W, LoCicero III J, Ponn R B. General thoracic surgery. Sternotomy and Thoracotomy for Mediastinal Disease. 5th ed. Philadelphia; LW & W 2000: 2073-2076
  • 2 Cooper J D, Nelem J M, Pearson F G. Extended indications for median sternotomy in patients requiring pulmonary resection.  Ann Thorac Surg. 1978;  26 413-420
  • 3 Baue A E, Geha A S, Hammond G L, Laks H, Naunheim K S. Glenn's Thoracic and Cardiovascular Surgery. Thoracic Incisons. 6th ed. London; Appleton & Lange 1996: 73-89
  • 4 Landreneau R J, Dowling R D, Castillo W M, Ferson P F. Thoracoscopic resection of an anterior mediastinal tumor.  Ann Thorac Surg. 1992;  54 142-144
  • 5 Gundry S R, Shattuck O H, Razzouk A J, del Rio M J, Sardari F F, Bailey L L. Facile minimally invasive cardiac surgery via mini-sternotomy.  Ann Thorac Surg. 1998;  65 1100-1104
  • 6 Grandjean J G, Lucchi M, Mariani M A. Reversed-T upper mini-sternotomy for extended thymectomy in myasthenic patients.  Ann Thorac Surg. 2000;  70 1423-1425
  • 7 Cooper J D, Al-Jilaihawa A N, Pearson F G, Humphrey J G, Humphrey H E. An improved technique to facilitate transcervical thymectomy for myasthenia gravis.  Ann Thorac Surg. 1988;  45 242-247
  • 8 Shimokawa S, Watanabe S-I, Sakasegawa K-I, Tani A. Ruptured thymoma causing mediastinal hemorrhage resected via partial sternotomy.  Ann Thorac Surg. 2001;  71 370-372

Dr. Shun-Ichi Watanabe

Second Department of Surgery · Kagoshima University Faculty of Medicine

8-35-1 Sakuragaoka

Kagoshima 890-8520

Japan

Phone: + 81992755368

Fax: + 81 9 92 65 81 77

Email: shun@khosp2.kufm.kagoshima-u.ac.jp