title: [Outcomes of Surgical Treatment by Modified Transmanubrial Approach].
abstract: OBJECTIVE
  The aim of this study is to evaluate the useful and safety of surgical treatment by modified transmanubrial approach(MTA).
  
  
  METHODS
  Between January 2000 and May 2014, 10 patients underwent surgical treatment by MTA. Among these patients, we retrospectively reviewed the medical records of 6 patients who had vascular invasion of tumor. We evaluated postoperative outcomes of MTA.
  
  
  RESULTS
  All patients were men, with a median age of 56 years. Pathological diagnoses were as follows:thymic carcinoma in 2, thyroid cancer in 2, primary lung cancer in 1, mediastinal lymph node metastasis of thyroid cancer in 1 patient. The median operative time was 468 minutes. The median bleeding was 1,723.5 ml. Four patients underwent angioplasty, including direct suture in 1, graft replacement artificial blood vessel in 3 patients. Right auricle-innominate vein bypass was performed in 3 patients. The median hospitalization term was 29 days. R0 resection was archived in all cases.
  
  
  CONCLUSIONS
  The surgical treatment by MTA is useful and safety for anterior apical tumor and mediastinal tumor invading adjacent vessels. Because of a small number of sample size, further investigation well be needed.
authors.affiliation: Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Mitsuboshi
authors.forename: Masato
authors.initials: M
authors.lastname: Kanzaki
authors.forename: Akira
authors.initials: A
authors.lastname: Ogihara
authors.forename: Sayaka
authors.initials: S
authors.lastname: Katagiri
authors.forename: Takehito
authors.initials: T
authors.lastname: Yoshiya
authors.forename: Kei
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Maeda
authors.forename: Takuma
authors.initials: T
authors.lastname: Kikkawa
authors.forename: Tamami
authors.initials: T
authors.lastname: Isaka
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Oyama
authors.forename: Masahide
authors.initials: M
authors.lastname: Murasugi
authors.forename: Takamasa
authors.initials: T
authors.lastname: Onuki
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008371:Manubrium; D008875:Middle Aged; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013964:Thyroid Neoplasms / Q000601:surgery; D016896:Treatment Outcome