Our Summary

This research paper discusses a new surgical technique for treating children with tumors in the upper part of the chest cavity. These tumors are often found late because they don’t cause symptoms until they’ve grown quite large. They can spread to the chest wall, spine, and major blood vessels, and can also grow into the area where the neck meets the chest. Treating these tumors can involve chemotherapy followed by surgery, or surgery alone.

The main challenge for surgeons is getting good enough access to these large tumors to remove them. Several different surgical techniques have been proposed, but all of them have problems because it’s hard to see and reach the whole tumor.

The authors of this paper propose a new surgical technique that involves making an incision along the breastbone and extending it into the neck. They report on two cases where they successfully used this technique to remove large tumors in the upper chest of children.

FAQs

  1. What is the main challenge for surgeons when treating children with tumors in the upper part of the chest cavity?
  2. What new surgical technique is proposed in this research paper for treating these tumors?
  3. Have there been successful cases using this new surgical technique for removing large tumors in the upper chest of children?

Doctor’s Tip

A doctor might tell a patient undergoing sternotomy that it is a surgical procedure in which the breastbone is cut to access the heart or chest cavity. They may advise the patient to follow post-operative care instructions carefully, including proper wound care, pain management, and physical therapy to promote healing and prevent complications. It is important for the patient to communicate any concerns or unusual symptoms to their healthcare provider promptly.

Suitable For

Patients who are typically recommended sternotomy for the removal of tumors in the upper chest cavity include:

  • Children with large tumors in the upper part of the chest cavity that are difficult to access using other surgical techniques
  • Patients with tumors that have spread to the chest wall, spine, major blood vessels, or the area where the neck meets the chest
  • Patients who have tumors that are causing symptoms or are at risk of causing complications if not removed promptly
  • Patients who have already undergone chemotherapy and may benefit from surgical removal of the tumor

Overall, sternotomy may be recommended for patients with complex or hard-to-reach tumors in the upper chest cavity, particularly in cases where other surgical techniques have proven challenging.

Timeline

Before sternotomy:

  • Patient is diagnosed with a tumor in the upper part of the chest cavity
  • Patient undergoes imaging tests to determine the size and location of the tumor
  • Treatment plan is discussed with the patient, including the option of surgery
  • Patient may undergo chemotherapy to shrink the tumor before surgery

After sternotomy:

  • Patient undergoes sternotomy surgery, where an incision is made along the breastbone and extended into the neck
  • Surgeons are able to access and remove the large tumor in the upper chest
  • Patient is monitored closely post-surgery for any complications or signs of infection
  • Patient undergoes follow-up appointments to ensure the tumor has been completely removed and to monitor for any signs of recurrence

Overall, sternotomy is a complex surgical procedure that requires careful planning and coordination between the surgical team and other healthcare providers. It can be a successful treatment option for patients with tumors in the upper chest cavity, allowing for complete removal of the tumor and potentially improving long-term outcomes for the patient.

What to Ask Your Doctor

  1. What is a sternotomy and why is it necessary for my treatment?
  2. What are the potential risks and complications associated with a sternotomy procedure?
  3. How will the sternotomy affect my recovery time and post-operative care?
  4. Are there any alternative surgical techniques that could be used instead of a sternotomy?
  5. What is the success rate of using a sternotomy for removing tumors in the upper chest cavity?
  6. Will I need additional treatments, such as chemotherapy, after the sternotomy procedure?
  7. How experienced is the surgical team in performing sternotomy procedures for treating tumors in the upper chest?
  8. What can I expect in terms of pain management and scarring after a sternotomy?
  9. Are there any long-term effects or complications associated with having a sternotomy?
  10. How soon can I expect to resume normal activities after undergoing a sternotomy procedure?

Reference

Authors: MacGregor RM, Wilson NA, Shakhsheer BA, Keller MS, Dillon PA, Abarbanell AM. Journal: J Pediatr Surg. 2021 Jun;56(6):1237-1241. doi: 10.1016/j.jpedsurg.2020.12.021. Epub 2021 Jan 7. PMID: 33485611