Abstract
The patient was a 65-year-old female with metastasis of thyroid papillary carcinoma at the right upper mediastinum. The tumor, which invaded almost the entire length of the right brachiocephalic vein, was resected via a modified trap-door thoracotomy. The modification was the additional resection of the first rib from inside the thorax, which provided a sufficient exposure from the distal side of the brachiocephalic and subclavian vein. Because the subclavian and internal jugular veins could be clamped under this thoracotomy, the entire right brachiocephalic vein could be reconstructed by graft without excessive difficulty. Modified trap-door thoracotomy is a useful approach in the resection of malignancies which invade the brachiocephalic and subclavian vein.
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References
Brawley RK, Murray GF, Crisler C, Cameron JL. Management of wounds of the innominate, subclavian, and axillary blood vessels. Surg Gynecol Obstet 1970; 131: 1130–40.
Dartevelle PG, Chapelier AR, Macchiarini P, Lenot B, Cerrina J, Ladurie FLR, et al. Anterior transcervical-thoracic approach for radical resection of lung tumors invading the thoracic inlet. J Thorac Cardiovasc Surg 1993; 105: 1025–34.
Flint LM, Synder WH, Perry MO, Shires GT. Management of major vascular injuries in the base of the neck. Arch Surg 1973; 106: 407–13.
George SMJr, Croce MA, Fabian TC, Mangiante EC, Kudsk KA, Voeller GR, et al. Cervicothoracic arterial injuries: recommendations for diagnosis and management. World J Surg 1981; 15: 134–40.
Graham JM, Feliciano DV, Mattox KL, Beall ACJr, DeBakey ME. Management of subclavian vascular injuries. J Trauma 1980; 20: 537–44.
Graham JM, Feliciano DV, Mattox KL, Beall ACJr. Innominate vascular injury. J Trauma 1982; 22: 647–55.
Steenburg RW, Ravitch MM. Cervicothoracic approach for subclavian vessel injury from compound fracture of the clavicle: considerations of subclavian-axillary exposures. Ann Surg 1963; 157: 839–46.
Nomori H, Nara S, Horio H. Modified trap-door thoracotomy for malignancies invading the subclavian and innominate vessels. Thorac Cardiovasc Surgeon 1995; 43: 204–7.
Nomori H, Horio H, Nara S. Synchronous reconstruction of the trachea and innominate artery in thyroid carcinoma. Ann Thorac Surg 1995; 60: 1421–2.
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Nomori, H., Horio, H. & Suemasu, K. Modified trap-door thoracotomy for mediastinal metastasis of thyroid carcinoma invading the right brachiocephalic vein. Jpn J Thorac Caridovasc Surg 48, 135–138 (2000). https://doi.org/10.1007/BF03218109
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DOI: https://doi.org/10.1007/BF03218109