Supraclavicular Approach Without Thoracotomy for Posterior Mediastinal Tumor

Abstract

Using a right-sided supraclavicular approach, we operated on a 15-year-old girl with a posterior mediastinal neurogenic tumor and von Recklinghausen's disease. The encapsulated 95 × 65 × 40 mm neurofibroma was removed safely and completely without thoracotomy. No peripheral neurologic defect such as Horner's syndrome, paralysis of accessory nerve, or palsy of the right upper extremity was observed after operation. The postoperative course was uneventful and the patient was discharged on the third postoperative day with no symptoms. Today, various adaptations of video-assisted thoracic surgery are frequently utilized for many lesions. However, more direct, safer, and less invasive approaches should be selected based on local anatomy, such as the supraclavicular approach without thoracotomy that we utilized.

Key words

Supraclavicular - approach - mediastinum - posterior mediastinal tumor - neurogenic

References

• 1 Lin J C, Landreneau R J. Video-assisted thoracic surgery for mediastinal tumors and cysts and other diseases within the mediastinum. Shields TW, LoCicero III J, Ponn RB General Thoracic Surgery. 5th ed. Philadelphia; Lippincott Williams & Wilkins 2000: 2079-2090
• 2 Kido T, Nishi H, Nakahara M, Nakao K. Transcervical, paratracheal resection of a posterior mediastinal mass.  J Thorac Cardiovasc Surg. 1999;  117 1036-1037
• 3 Rosai J. Neurofibromatosis. Rosai J Ackerman's Surgical Pathology. 8th ed. St. Louis; Mosby 1996: 2046-2049
• 4 Reynolds M, Shields T W. Benign and malignant mediastinal neurogenic tumors in infants and children. Shields TW, LoCicero III J, Ponn RB General Thoracic Surgery. 5th ed. Philadelphia; Lippincott Williams & Wilkins 2000: 2301-2312
• 5 Crawford Jr F A, Kratz J M. Thoracic incisions. Sabiston DC Jr, Spencer FC Surgery of the Chest. 5th ed. Philadelphia; WB Saunders Company 1990: 189-201