OBJECTIVE

To study the immediate results of using the combined anterior approach in the treatment of patients with thoracic tumors.

MATERIAL AND METHODS

The investigation enrolled 28 patients, to whom a combination approach was applied during surgery for intrathoracic tumors in 2008 to 2021. The mean age of the patients was 45 years and ranged from 18 to 71 years. Before contacting the authors’ Institute, 6 (21%) patients have failed attempts to remove the tumor. The latter was located in the anterior mediastinum in 11 (40%) patients, in an average of 2 (7%), in the posterior mediastinum in 7 (25%), in the right hemithorax in 6 (21%), in the left hemithorax in 2 (7%), on the right in 15 (53%) and on the left in 13 (47%). There was a preponderance of patients with neurogenic tumors of the mediastinum (7; 25%), neoplasms of the thymus (5; 17.8%), or cancer of the lung (4; 14.2%). The mean size of the resected tumor was 107±55 mm (95% CI 85-128 mm).

RESULTS

The operation was combined in 15 (53%) of the 28 patients; multiple organ resections were more often performed. Radical surgery was done in 97% of patients. The complicated postoperative period was generally observed in 6 (21%) patients; the mortality rate was 7%. The expansion of the intervention volume statistically significantly correlated with a higher blood loss and length of hospital stay.

CONCLUSION

Anterior combined approaches combining sternotomy, thoracotomy, and those supplemented by a cervical incision allow expanding the possibilities of surgical treatment in patients with the resectable tumor localized in the mediastinum and the area of the superior thoracic aperture.