title: Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma: A Novel Mini-Invasive Technique.
abstract: We report a novel less-invasive extrapleural pneumonectomy for early-stage malignant pleural mesothelioma without rib spreading. Our approach is unique and differed from the previously reported cases, because we used one skin incision and two small intercostal incisions with videothoracoscopic viewing without rib spreading. The pleural dissection and approach to the hilum for pneumonectomy were performed through a 4- to 5-cm port incision in the sixth intercostal space. Another 4- to 5-cm port was made in the eight intercostal space through the same skin incision and was used for diaphragm resection and reconstruction. At the end of the surgery, the skin incision was enlarged to 8 cm; through which and the first port in the sixth intercostal space, the resected specimen was retrieved. Three cycles of adjuvant chemotherapy followed by radiation therapy were administered. Eleven-month follow-up showed no recurrence.
authors.affiliation: From the *Thoracic Surgery Unit, Istituto Oncologico del Mediterraneo, Catania, Italy; and †Thoracic Surgery Unit, Second University of Naples, Naples, Italy. Francesco Paolo Caronia, MD, and Alfonso Fiorelli, MD, PhD, contributed equally to prepare this article.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Caronia
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
authors.forename: Ettore
authors.initials: E
authors.lastname: Arrigo
mesh_terms: D059248:Chemoradiotherapy; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008654:Mesothelioma / Q000473:pathology / Q000628:therapy*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000473:pathology / Q000628:therapy*; D011013:Pneumonectomy / Q000379:methods*; D016896:Treatment Outcome