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Ann Thorac Surg 1979;28:90-93
© 1979 The Society of Thoracic Surgeons

Articles

Supraclavicular Thoracotomy for Diagnosis of Apical Lung and Superior Mediastinal Lesions

Charles H. Dart, Jr., M.D.*, Howard E. Braitman, M.D., Somboon Larlarb, M.D.

From St. John's Hospital, Oxnard, and the Department of Thoracic Surgery, UCLA Medical School, Los Angeles, CA

Accepted for publication November 15, 1978.

* Address reprint requests to Dr. Dart, 500 Esplanade Dr, Suite 700, Oxnard, CA 93030

Despite the use of mediastinoscopy, anterior mediastinotomy, transcarinal biopsy, needle biopsy, and transbronchial fluoroscopic brushing, thoracotomy is necessary to obtain tissue for diagnosis in patients suspected of having carcinoma of the lung. A technique we have employed is exploratory thoracotomy, as described for the approach to cervical and upper dorsal sympathetic ganglion, with entrance into the pleural space through a supraclavicular incision. Five patients, 3 with marginal pulmonary function and 2 with brachial plexus and upper mediastinal or vertebral involvement, had tissue diagnosis of lung carcinoma by this method without postoperative complication.

Supraclavicular thoracotomy offers a safe, easy, and definitive method of tissue diagnosis of apical lung and superior mediastinal lesions.






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Copyright © 1979 by The Society of Thoracic Surgeons.