Interactive Cardiovascular and Thoracic Surgery. 3:201-203(2004) [Link]
Kameyama K, Huang CL, Hayashi E, Yokomise H.
Second Department of Surgery, Kagawa Medical University, 1750-1, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Extrapleural pneumonectomy is an essential procedure in multimodality therapy of malignant pleural mesothelioma. However, radical resection may be difficult in a standard posterolateral thoracotomy because the edge of the diaphragm is located in the dead angle of the pleural cavity. We have tried a subcostal thoracotomy following a posterolateral thoracotomy (extended posterolateralâ€“subcostal thoracotomy) for extrapleural pneumonectomy. With extended posterolateralâ€“subcostal thoracotomy, ideal surgical resection, with en bloc removal of the lung, parietal pleura, pericardium and diaphragm, can be performed radically, but safely, without a second thoracotomy. We conclude that extended posterolateralâ€“subcostal thoracotomy is an effective approach for extrapleural pneumonectomy.
Keywords: Thoracotomy; Pleural cavity; Mesothelioma; Pleural disease; Diaphragm