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Three-dimensional multidetector computed tomography may aid preoperative planning of the transmanubrial osteomuscular-sparing approach to completely resect superior sulcus tumor

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Abstract

The anterior transcervical-thoracic approach clearly exposes the subclavian vessels and brachial plexus. We believe that this approach is optimal when a superior sulcus tumor (SST) invades the anterior part of the thoracic inlet. However, this approach is not yet widely applied because anatomical relationships in this procedure are difficult to visualize. Three-dimensional tomography can considerably improve preoperative planning, enhance the surgeon’s skill and simplify the approach to complex surgical procedures. We applied preoperative 3-dimensional multidetector computed tomography to a case where an SST had invaded the anterior part of the thoracic inlet including the clavicle, sternoclavicular joint, first rib, subclavian vessels and brachial plexus. After the patient underwent induction chemotherapy, we performed the transmanubrial osteomuscular-sparing approach and added a third anterolateral thoracotomy with a hemi-clamshell incision and completely resected the tumor.

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Abbreviations

3-D:

Three dimensional

CT:

Computed tomography

DICOM:

Digital imaging and communication in medicine

MD:

Multidetector

SST:

Superior sulcus tumor

VATS:

Video-assisted thoracoscopic surgery

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Acknowledgments

We are indebted to Ms. Jessica Bentz and Associate Professor Edward F. Barroga (D.V.M., Ph.D.) of the Department of International Medical Communications of Tokyo Medical University, for their editorial review of the English manuscript. This study was supported by a Grant-in-Aid for Scientific Research, Japan Society for the Promotion of Science (24592104), Ministry of Education, Culture, Sports, Science and Technology, Japan.

Conflict of interest

Two authors (H.S. and N.I.) have given remunerated lectures for Fujifilm. No author received research funding and all had full control of the study design, methods used, outcome parameters, data analysis and production of the written report.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Hisashi Saji, Yasufumi Kato, Yoshihisa Shimada, Yujin Kudo, Masaru Hagiwara & Norihiko Ikeda

  2. Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Jun Matsubayashi & Toshitaka Nagao

  3. Department of Chest Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Hisashi Saji

Authors
  1. Hisashi Saji
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  2. Yasufumi Kato
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  3. Yoshihisa Shimada
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  4. Yujin Kudo
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  5. Masaru Hagiwara
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  6. Jun Matsubayashi
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  7. Toshitaka Nagao
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  8. Norihiko Ikeda
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Corresponding author

Correspondence to Hisashi Saji.

Additional information

This study was presented at the 65th Annual Scientific Meeting of the Japanese Association for Thoracic Surgery.

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Saji, H., Kato, Y., Shimada, Y. et al. Three-dimensional multidetector computed tomography may aid preoperative planning of the transmanubrial osteomuscular-sparing approach to completely resect superior sulcus tumor. Gen Thorac Cardiovasc Surg 63, 627–631 (2015). https://doi.org/10.1007/s11748-013-0368-4

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  • DOI: https://doi.org/10.1007/s11748-013-0368-4

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