Cervico-thoracic tumors resection through transmanubrial osteomuscular sparing approach

Twelve patients with cervico-thoracic tumors underwent transmanubrial appro ach during a 1-year period. All but two patients with NSCLC (n = 8), had do uble approaches. Three cases with cervical esophageal cancer underwent TMA and laparotomy. The last patient underwent TMA for cervical fibrosarcoma. O ne patient underwent subclavian artery resection, while another one resecti on of the left brachicephalic vein with graft replacement. Two cases, in th e esophageal cancer group, had laryngeal nerve palsy requiring temporary tr acheostomy. TMA affords an excellent exposure of the thoracic in/outlet all owing extended resection. Sparing the main osteo-muscular structures, it re spects shoulder mobility of the scapular girdle, thus avoiding deformities due to clavicle resection. (C) 1999 Elsevier Science B.V. All rights reserv ed.