Transsternal Bilateral Thoracotomy (The Clamshell Incision) for Bilateral Metastatic Lung Cancer : Case Report
A transsternal bilateral thoracotomy (clamshell incision) was successfully performed in a 69-year-old male. The patient had bilateral metastatic lung cancer from a primary colon cancer. An inframammary incision was made while the patient was in a supine position. The chest was entered via the 4 th i...
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| Published in | Kita Kantō igaku (The Kitakanto Medical Journal) Vol. 51; no. 5; pp. 321 - 324 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
The Kitakanto Medical Society
2001
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1343-2826 1881-1191 |
| DOI | 10.2974/kmj.51.321 |
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| Abstract | A transsternal bilateral thoracotomy (clamshell incision) was successfully performed in a 69-year-old male. The patient had bilateral metastatic lung cancer from a primary colon cancer. An inframammary incision was made while the patient was in a supine position. The chest was entered via the 4 th intercostal space ; right segments 3, 4 and 8, and the left upper lobe were resected. Postoperative pain was well controlled using an epidural block. This procedure provides a sufficient surgical field enabling manipulation throughout the entire thoracic space and the mediastinum using a single operative field. Thus transsternal bilateral thoracotomy is a useful procedure for one-stage surgeries in patients with bilateral lung tumors. |
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| AbstractList | A transsternal bilateral thoracotomy (clamshell incision) was successfully performed in a 69-year-old male. The patient had bilateral metastatic lung cancer from a primary colon cancer. An inframammary incision was made while the patient was in a supine position. The chest was entered via the 4 th intercostal space ; right segments 3, 4 and 8, and the left upper lobe were resected. Postoperative pain was well controlled using an epidural block. This procedure provides a sufficient surgical field enabling manipulation throughout the entire thoracic space and the mediastinum using a single operative field. Thus transsternal bilateral thoracotomy is a useful procedure for one-stage surgeries in patients with bilateral lung tumors. |
| Author | Sakata, Kazuhiro Morishita, Yasuo Otani, Yoshimi Ibe, Takashi Kawashima, Osamu Sugano, Masayuki Kamiyoshihara, Mitsuhiro |
| Author_xml | – sequence: 1 fullname: Kawashima, Osamu organization: Department of Surgery, National Sanatorium, Nishigunma Hospital – sequence: 1 fullname: Morishita, Yasuo organization: Second Department of Surgery, Gunma University School of Medicine – sequence: 1 fullname: Kamiyoshihara, Mitsuhiro – sequence: 1 fullname: Otani, Yoshimi organization: Second Department of Surgery, Gunma University School of Medicine – sequence: 1 fullname: Sakata, Kazuhiro organization: Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital – sequence: 1 fullname: Sugano, Masayuki organization: Second Department of Surgery, Gunma University School of Medicine – sequence: 1 fullname: Ibe, Takashi organization: Department of Surgery, National Sanatorium, Nishigunma Hospital |
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| References | 1. Rusch VW. Pulmonary metastasectomy. Current indications. Chest 1995 ; 107 : 322s-331s. 13. 佐伯普成, 岩崎達雄, 時岡宏明.胸骨横切開による両側肺部分切除術が術後呼吸機能に及ぼす影響.臨床呼吸生理 1992 ; 24 : 61-63. 8. Mansel JK, Zinsmeister AR, Pairolero PC, et al. Pulmonary resection of metastatic colorectal adenocarcinoma. A ten-year experience. Chest 1986 ; 89 : 109-112. 9. Kamiyoshihara M, Yoshida I, Ishikawa S, et al. Resection of Pulmonary and antecedent hepatic metastases from colon cancer : Report of A Case. KitaKanto Med J 2000 ; 50 : 305-307. 12. 大鹿芳郎, 出口博之, 佐藤光春ら.転移性肺腫瘍に対する胸骨横切開法による一期的両側肺手術例の検討.胸部外科 1999 ; 52 : 983-987. 11. Shimizu J, Oda M, Morita K, et al. Evaluation of the clamshell incision for bilateral pulmonary metastases. Int Surg 1997 ; 82 : 262-265. 10.大畑正明, 大森和光, 伊良子光正ら.胸骨横切開による両側肺手術.日外会誌 1991 ; 92 : 862-866. 4. Takita H, Merrin C, Didolkar MS, Douglass HO and Edgerton F : The surgical management of multiple lung metastases. Ann Thorac Surg 24 : 359-364, 1977. 14. 住友伸一.開胸手術が胸郭運動に及ぼす影響についての臨床的研究.日胸外会誌 1998 ; 36 : 1995-1998. 7. Goya T, Miyazawa N, Kondo H, et al. Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up. Cancer 1989 ; 64 : 1418- 1421. 2. Thomford NR, Woolner LB, Clagett OT, et al. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg 1965 ; 49 : 357-363. 3. Kamiyoshihara M, Hirai T, Kawashima O, et al. The surgical treatment of metastatic tumors in the lungs : Is lobectomy with mediastinal lymph node dissection suitable treatment?. Oncol Rep 1998 ; 5 : 453-457. 5. Kamiyoshihara M, Hirai T, Kawashima O, et al. Resection of pulmonary metastases in six cases with disease-free interval greater than 10 years. Ann Thorac Surg 1998 ; 66 : 231-233. 6. Yano T, Hara N, Ichinose Y, et al. Results of pulmonary resection of metastatic colorectal cancer and its application. J Thorac Cardiovasc Surg 1993 ; 106 : 875-879. |
| References_xml | – reference: 11. Shimizu J, Oda M, Morita K, et al. Evaluation of the clamshell incision for bilateral pulmonary metastases. Int Surg 1997 ; 82 : 262-265. – reference: 3. Kamiyoshihara M, Hirai T, Kawashima O, et al. The surgical treatment of metastatic tumors in the lungs : Is lobectomy with mediastinal lymph node dissection suitable treatment?. Oncol Rep 1998 ; 5 : 453-457. – reference: 9. Kamiyoshihara M, Yoshida I, Ishikawa S, et al. Resection of Pulmonary and antecedent hepatic metastases from colon cancer : Report of A Case. KitaKanto Med J 2000 ; 50 : 305-307. – reference: 2. Thomford NR, Woolner LB, Clagett OT, et al. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg 1965 ; 49 : 357-363. – reference: 4. Takita H, Merrin C, Didolkar MS, Douglass HO and Edgerton F : The surgical management of multiple lung metastases. Ann Thorac Surg 24 : 359-364, 1977. – reference: 10.大畑正明, 大森和光, 伊良子光正ら.胸骨横切開による両側肺手術.日外会誌 1991 ; 92 : 862-866. – reference: 8. Mansel JK, Zinsmeister AR, Pairolero PC, et al. Pulmonary resection of metastatic colorectal adenocarcinoma. A ten-year experience. Chest 1986 ; 89 : 109-112. – reference: 1. Rusch VW. Pulmonary metastasectomy. Current indications. Chest 1995 ; 107 : 322s-331s. – reference: 5. Kamiyoshihara M, Hirai T, Kawashima O, et al. Resection of pulmonary metastases in six cases with disease-free interval greater than 10 years. Ann Thorac Surg 1998 ; 66 : 231-233. – reference: 7. Goya T, Miyazawa N, Kondo H, et al. Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up. Cancer 1989 ; 64 : 1418- 1421. – reference: 6. Yano T, Hara N, Ichinose Y, et al. Results of pulmonary resection of metastatic colorectal cancer and its application. J Thorac Cardiovasc Surg 1993 ; 106 : 875-879. – reference: 13. 佐伯普成, 岩崎達雄, 時岡宏明.胸骨横切開による両側肺部分切除術が術後呼吸機能に及ぼす影響.臨床呼吸生理 1992 ; 24 : 61-63. – reference: 14. 住友伸一.開胸手術が胸郭運動に及ぼす影響についての臨床的研究.日胸外会誌 1998 ; 36 : 1995-1998. – reference: 12. 大鹿芳郎, 出口博之, 佐藤光春ら.転移性肺腫瘍に対する胸骨横切開法による一期的両側肺手術例の検討.胸部外科 1999 ; 52 : 983-987. |
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| SubjectTerms | Clamshell incision Metastatic lung cancer Trans-sternal thoractomy |
| Title | Transsternal Bilateral Thoracotomy (The Clamshell Incision) for Bilateral Metastatic Lung Cancer : Case Report |
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