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Ann Thorac Surg 2000;69:1961-1963
© 2000 The Society of Thoracic Surgeons

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The modified "hemi-clamshell" approach for tumors of the cervicothoracic junction

Michele Rusca, MDa, Paolo Carbognani, MD, PhDa, Paolo Bobbio, MDa

a Department of Thoracic Surgery, University of Parma, Parma, Italy

Address reprint requests Dr Rusca, Department of Thoracic Surgery, University of Parma, Via Gramsci 14, 43100 Parma, Italy

The anterior approaches proposed for treatment of the apical chest tumors (anterior transcervical, transmanubrial, and hemi-clamshell) have precise advantages and limits. To avoid these limits we have modified the hemi-clamshell with the resection of the first costal cartilage and the costoclavicular ligament. This allows a wider opening of the sternocostal flap, with safe control of the entire subclavian vessels as well as easier access to the T1 to T3 vertebral bodies and the posterior chest wall.




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