Thoracoabdominal incisions and resection of upper retroperitoneal sarcomas

Background and Objectives: There is a widespread impression among surgeons that a thoracoabdominal incision carries a substantially higher risk of mor bidity and possible mortality over abdominal incisions. We decided therefor e to critically review our experience of the last 4 years with these incisi ons. Methods: This is a retrospective review of all cases of retroperitoneal sar comas of upper abdominal quadrants in the period May 1995 through February 1999. There were 33 consecutive patients and 34 thoracoabdominal incisions (1 patient had a second operation for recurrence). Their mean age was 54 ye ars, with 13 >60 and 7 >70 years. Results: Eighteen patients were extubated immediately at the end of the pro cedure and the rest within 24 h. in the majority of instances (32 of 34 or 94%), the patients left the intensive care unit within 48 h. The most commo n postoperative complication was atelectasis (7 of 34, 21%). There was no p ostoperative death. The retroperitoneal tumor was resected in all 34 cases (100%). Conclusions: The thoracoabdominal incision for upper quadrant retroperitone al sarcomas is tolerated well by the patients with a morbidity similar to t hat observed after routine abdominal incisions. It allows complete resectio n of the tumor in most (all in this series) cases. (C) 1999 Wiley-Liss, Inc .