Original Article
Surgical strategies and approaches for the management of tumors at cervicothoracic junction
Wang Shuai, Tan Lijie, Ge Di, Qi Fazhi, Zhang Yong, Zhu Ting, Chen Zenggan, Jiang Wei, Wang Qun
Published 2021-06-25
Cite as Chin J Thorac Cardiovasc Surg, 2021, 37(6): 358-362. DOI: 10.3760/cma.j.cn112434-20200909-00414
Abstract
ObjectiveTo investigate the surgical treatment of the tumors at cervicothoracic junction.
MethodsA retrospective analyses was performed for 63 patients with tumors at the cervicothoracic junction receiving surgery from Mar 2008 to May 2020 in the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University. Clinical data about manifestation, surgical approach, resection degree and pathological types were collected. There were 43 cases of asymptomatic patients and 20 cases of patients with ≥1 clinical manifestations. Twenty two patients receiving radical resection with video-assisted thoracoscopic surgery. Anterior approach was the most popular treatment in open surgery (24 cases, 38.1%), and 8 cases of anterolateral approach(6 cases of Hemiclamshell incisions, 2 cases of trap-door incisions), 1 case of posterior approach, 2 cases of posterolateral approach and 1 case of supraclavicular combined posterolateral approach.
ResultsPathological examination suggested 61 cases of radical resection and 2 cases of microscopic residual. Neurilemmoma was the most common pathological type (27 cases, 42.9%), the second common pathological type was tumor originated from fibrous tissues (6 cases, 9.5%). The 3-year overall survival rate of those 63 patients was 88.9%, while the 5-year overall survival rate was 84.1%.
ConclusionTumors involving the cervicothoracic junction are characterized as special location, complicated anatomy and various histopathological subtypes. Individualized approach and surgery improve safety and normalization of tumors at cervicothoracic junction treatment.
Key words:
Tumors; Cervicothoracic junction; Surgical approach; Hemiclamshell
Contributor Information
Wang Shuai
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Tan Lijie
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Ge Di
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Qi Fazhi
Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Zhang Yong
Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Zhu Ting
Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Chen Zenggan
Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Jiang Wei
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Wang Qun
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China