title: The surgical approach for cervicothoracic masses in children.
abstract: BACKGROUND
  The surgical approach to masses located in the cervicothoracic juncton represents a challenge for surgeons. Many techniques have been described with good results.
  
  
  METHODS
  We analyzed and compared the results obtained in 2 Italian pediatric surgery centers using 2 different techniques in patients with tumors of the thoracic inlet: center 1, using anterior cervical transsternal approach on 7 patients, and center 2, applying "trap-door" technique on 5 patients.
  
  
  RESULTS
  Excision was incomplete in 5 patients and complete in 7 patients. Histologic examination revealed 5 patients with neuroblastoma; 3, ganglioneuroblastoma; 1, mixoid liposarcoma; 1, desmoid fibromatosis; 1, Castleman disease; and 1, Schwann cell tumor. The median duration of the procedure was 345 minutes in center 1 and 245 minutes in center 2. The median blood loss was 200 mL in both centers. The median hospital stay was 11 days in center 1 and 9 days in center 2. Globally, 5 patients developed postoperative complications. No significant differences were encountered comparing the main surgical outcome parameters between the 2 approaches.
  
  
  CONCLUSIONS
  Both techniques resulted in valid options to achieve a safe excision of thoracic inlet masses with a manageable complication rate and acceptable hospital stay. Surgical risk factors should be carefully investigated preoperatively. Postoperative pain control is important to guarantee early recovery.
authors.affiliation: Division of Pediatric Surgery, Pediatric Department, University-Hospital of Padua, 35128 Padua, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: De Corti
authors.forename: Stefano
authors.initials: S
authors.lastname: Avanzini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cecchetto
authors.forename: Piero
authors.initials: P
authors.lastname: Buffa
authors.forename: Edoardo
authors.initials: E
authors.lastname: Guida
authors.forename: Giovanni F
authors.initials: GF
authors.lastname: Zanon
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Jasonni
mesh_terms: D005871:Castleman Disease / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D018222:Desmoid Tumors / Q000601:surgery; D018305:Ganglioneuroblastoma / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008080:Liposarcoma / Q000601:surgery; D008297:Male; D009442:Neurilemmoma / Q000601:surgery; D009447:Neuroblastoma / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications; D012189:Retrospective Studies; D056346:Sternotomy / Q000379:methods*; D013899:Thoracic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome