THORACOSCOPIC SURGERY COMBINED WITH A SUPRACLAVICULAR APPROACH FOR REMOVING SUPERIOR MEDIASTINAL TUMOR

This report introduces our new technique of thoracoscopic surgery comb ined with a supraclavicular approach for removing superior mediastinal tumor. A 68-year-old woman noticed a tumor palpable in the left supra clavicular fossa. The patient had no pain around the neck and shoulder . A radio-opaque shadow 6 cm in diameter was detected in her left apic al lung field on chest roentgenogram. Chest CT and MRI showed that the tumor was located in the superior mediastinum. extending up to the th oracic inlet, and there was no invasion of the surroundings. At first, a thoracoscopic examination was performed to assess tile possibility of the excision. After dissecting the tumor from the mediastinal tissu e and the first costovertebrae as far as possible by thoracoscopic sur gery, a supraclavicular approach was used to enter the thoracic cavity . Complete resection of the tumor was successfully performed by thorac oscopic surgery combined with a supraclavicular approach. The tumor wa s removed in a plastic bag through the supraclavicular defect. Postope rative histopathology revealed that the tumor was a benign neurogenic one. A satisfactory follow-up of 5 postoperative days was observed wit hout ally complications, and the patient was discharged. The procedure was safe, easy, and minimally invasive tu perform. Moreover, the supr aclavicular approach could be used to add trocar port if needed.