title: Thoracoscopic surgery combined with a supraclavicular approach for removing superior mediastinal tumor.
abstract: This report introduces our new technique of thoracoscopic surgery combined with a supraclavicular approach for removing superior mediastinal tumor. A 68-year-old woman noticed a tumor palpable in the left supraclavicular fossa. The patient had no pain around the neck and shoulder. A radio-opaque shadow 6 cm in diameter was detected in her left apical lung field on chest roentgenogram. Chest CT and MRI showed that the tumor was located in the superior mediastinum, extending up to the thoracic inlet, and there was no invasion of the surroundings. At first, a thoracoscopic examination was performed to assess the possibility of the excision. After dissecting the tumor from the mediastinal tissue and the first costovertebrae as far as possible by thoracoscopic surgery, a supraclavicular approach was used to enter the thoracic cavity. Complete resection of the tumor was successfully performed by thoracoscopic surgery combined with a supraclavicular approach. The tumor was removed in a plastic bag through the supraclavicular defect. Postoperative histopathology revealed that the tumor was a benign neurogenic one. A satisfactory follow-up of 5 postoperative days was observed without any complications, and the patient was discharged. The procedure was safe, easy, and minimally invasive to perform. Moreover, the supraclavicular approach could be used to add trocar port if needed.
authors.affiliation: Department of Surgery, Takarazuka City Hospital, Hyogo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Akashi
authors.forename: S
authors.initials: S
authors.lastname: Ohashi
authors.forename: Y
authors.initials: Y
authors.lastname: Yoden
authors.forename: H
authors.initials: H
authors.lastname: Kanno
authors.forename: K
authors.initials: K
authors.lastname: Tei
authors.forename: H
authors.initials: H
authors.lastname: Sasaoka
authors.forename: Y
authors.initials: Y
authors.lastname: Sakamaki
authors.forename: T
authors.initials: T
authors.lastname: Katsura
authors.forename: M
authors.initials: M
authors.lastname: Nishino
authors.forename: H S
authors.initials: HS
authors.lastname: Manzurul
mesh_terms: D000368:Aged; D002968:Clavicle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed