2005
DOI: 10.1016/j.athoracsur.2005.02.012
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Alternative Surgical Approaches for Apical Neurinomas: A Thoracoscopic Approach

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Cited by 24 publications
(24 citation statements)
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“…As the tumour is located in a narrow space and adjacent to important vessels and nerves, and its anatomy is complicated, thoracoscopy is difficult to perform and the complication ratio is high. In this group, half of the posterior mediastinal neurogenic tumours with diameter ≥6 cm were located at the cupula of the pleura region, and for 60% (3/5) cases of the conversion to thoracotomy and 42.9% (3/7) cases of surgical complication, the tumours were located at the apex of pleura, which indicated the difficulty and risk of thoracoscopic surgery in this region, and were consistent with the literature . In the earlier inexperienced period, we intended to strip the tumour together with its capsule, resulting in unclear visual field, significant haemorrhage and post‐operative nerve injury complication.…”
Section: Commentssupporting
confidence: 77%
“…As the tumour is located in a narrow space and adjacent to important vessels and nerves, and its anatomy is complicated, thoracoscopy is difficult to perform and the complication ratio is high. In this group, half of the posterior mediastinal neurogenic tumours with diameter ≥6 cm were located at the cupula of the pleura region, and for 60% (3/5) cases of the conversion to thoracotomy and 42.9% (3/7) cases of surgical complication, the tumours were located at the apex of pleura, which indicated the difficulty and risk of thoracoscopic surgery in this region, and were consistent with the literature . In the earlier inexperienced period, we intended to strip the tumour together with its capsule, resulting in unclear visual field, significant haemorrhage and post‐operative nerve injury complication.…”
Section: Commentssupporting
confidence: 77%
“…No conversion was required in our study. However, in the case of surgical difficulties, magnificence of the operative field allows a good evaluation of the local anatomy before committing the patient to an open thoracotomy [29]. Nevertheless, the favorable behavior of the tumors in the present series must be put into context of slightly aggressive tumors.…”
Section: Resultsmentioning
confidence: 97%
“…On one hand, apical tumors must be submitted to traction to be correctly dissected; this can result in temporary sympathetic lesions such as Horner syndrome. On the other hand, electrocoagulation and the spread of electric current or dispersion of heat could induce nerve injuries and temporary Horner syndrome [27][28][29], or peripheral lesions in lung parenchyma. Under thoracoscopy, because of the proximity between the surgeon's eyes and the tumor, roots of neurogenic tumors are easy to individualize and no excessive traction should be done with instrument in order not to stretch medullar roots.…”
Section: Discussionmentioning
confidence: 99%
“…To remove dumbbell tumours several surgical techniques have been published [14][15][16][17]. Akwari et al [18] described posterior laminectomy and, where necessary, adding costotransversectomy.…”
Section: Discussionmentioning
confidence: 99%