Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Treatment of pancoast tumors from the surgeons prospective: re-appraisal of the anteriormanubrial sternal approach. | Parissis and Young Journal of Cardiothoracic Surgery 2010 5 102 http content 5 1 102 JOTS JOURNAL OF CARDIOTHORACIC SURGERY REVIEW Open Access Treatment of pancoast tumors from the surgeons prospective re-appraisal of the anterior-manubrial sternal approach Haralabos Parissis 1 Vincent Young2 Abstract Pancoast tumours are now amenable to multimodality treatment with an acceptable survival. This is because trimodality treatment improves tumor sterilization and hence outcome. Moreover the development of an anterior approach to access the tumor further improved the technical challenges for a sound resection. The Anterior-manubrial sternal approach was described more than a decade ago and although this method facilitates better exposure of the extreme apex of the lung brachial plexus and subclavian vessels its popularity has not reached high levels. We felt that by re-addressing this topic we would stimulate reconsideration of the anterior approach. Introduction Pancoast syndrome is due to lesions extending to the superior thoracic inlet. Specific symtomatology mainly due to brachial plexus invasion accounts for the majority of those cases 1-3 . Pancoast tumour is a tumour of the apex of the lung with no intervening lung tissue between tumour and chest wall. Subsequently there is an involvement of structures of the apical chest wall above the level of the second rib. Almost half of the treated cancers are squamous cell carcinomas 45-50 while the rest are either adenocarcinomas 36-38 or undifferentiated large-cell carcinomas 11-13 . The tumour rapidly involves the structures of the thoracic inlet the root of neck. Due to its localization in the apex of the lung invasion of the lower part of the brachial plexus first ribs vertebrae subclavian vessels or stellate ganglion occurs 4 . The classical Pancoast presentation with shoulder pain radiating to the ulnar side of the arm and the hand is presented in 55 to 60 of the patients. Pain at the .
