The Annals of Thoracic Surgery, Vol 28, 90-93, Copyright © 1979 by The Society of Thoracic Surgeons
Supraclavicular thoracotomy for diagnosis of apical lung and superior mediastinal lesions
CH Dart Jr, HE Braitman and S Larlarb
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.