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Il Giornale di Chirurgia

Cervico-manubrio-toracotomia secondo Grünenwald.
Nostra esperienza in 3 casi di tumori dello stretto toracico superiore

Articolo, 203 - 204
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Tumors of the cervical-thoracic area can be treated by the Grünenwald approach, which consists of an L-shaped cervical-manubrialthoracotomy without section of the clavicle. We used this access in three different tumors of the cervical-thoracic inlet: a tumor of T1 vertebral body, a tumor of the left superior sulcus, and a rare tumor originating from the root T1 of the brachial plexus. The first patient was a 39-years-old man with a somatic fracture of T1 and tumor invasion of the residual vertebral body by multiple myeloma. The 2nd patient was a 61-years-old man with a squamous cell carcinoma of S1 left upper lobe, infiltrating the parietal pleura and the chest wall, in the anterior-lateral part of the 2nd intercostal space. The 3rd patient was a 35-years-old woman with a glomic tumor originating from the T1 root of the right brachial plexus. The only post-operative complication was a modest diaphragm elevation in the 3rd patient, completely disappeared after 3-4 months. The 2nd patient is dead one year after the operation for cerebral metastases. The other two patients are presently in good conditions, without signs of relapse. Is our opinion the Grünenwald technique is technique for the treatment of tumors of the cervical-thoracic area allows a safe visibility of the anatomical structures without the necessity of a clavicle section.

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