The utility of muscle-sparing axillar skin crease incision with thoracoscopic surgery in children

Ryota Souzaki, Naonori Kawakubo, Kina Miyoshi, Satoshi Obata, Yoshiaki Kinoshita, Junkichi Takemoto, Kenichi Kohashi, Yoshinao Oda, Tomoaki Taguchi

Research output: Contribution to journalArticle

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Abstract

Background: Thoracoscopic surgery for pediatric benign tumors is a common procedure. However, a large incision is needed to remove large tumors from the thoracic cavity. And, for intrapulmonary sequestration in lower lobe, it sometimes needs a large incision to ligate the aberrant vessels. A muscle-sparing axillar skin crease incision (MSASCI) has been introduced for thoracic open surgery, resulting in excellent aesthetic outcomes compared with a standard incision. We herein report the utility of this MSASCI technique in thoracoscopic surgery to remove large tumors from the thoracic cavity and to ligate the aberrant vessels in intrapulmonary sequestration in lower lobe. Materials and Methods: From 2014 April to 2016 March, we performed the MSASCI technique in thoracoscopic surgeries for 5 children. Result: Five cases were diagnosed as mediastinal masses (mature teratoma for 1 case, ganglioneuroblastoma for 2 cases, and extrapulmonary sequestration and intrapulmonary sequestration for 1 case each). The age at surgery was 32.0 ± 25.0 months (range 5-58 months). The size of the mediastinal mass was 9 × 5 × 5 cm, 4 × 3 × 3 cm, 5 × 5 × 2.5 cm, and 3 × 2.5 × 2 cm. For 4 other cases, except for the intrapulmonary sequestration case, the mass was resected under thoracoscopic surgery using only three or four 5-mm trocars and the mass was removed from the thoracic cavity using the MSASCI technique. For the intrapulmonary sequestration case, the aberrant vessels were resected under thoracoscopic surgery using only two 5-mm and one 12-mm trocars and the left lower lobectomy was performed using the MSASCI technique. All lesions were resected completely. No cases had surgical complications, none showed recurrence, and all cases demonstrated good cosmetic outcomes. Conclusions: Performing thoracoscopic surgery using a MSASCI technique is associated with good cosmetic outcome.

Original languageEnglish
Pages (from-to)1378-1382
Number of pages5
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume28
Issue number11
DOIs
Publication statusPublished - Nov 2018

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Thoracoscopy
Thoracic Cavity
Muscles
Skin
Surgical Instruments
Cosmetics
Ganglioneuroblastoma
Neoplasms
Teratoma
Esthetics
Thoracic Surgery
Pediatrics
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery

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The utility of muscle-sparing axillar skin crease incision with thoracoscopic surgery in children. / Souzaki, Ryota; Kawakubo, Naonori; Miyoshi, Kina; Obata, Satoshi; Kinoshita, Yoshiaki; Takemoto, Junkichi; Kohashi, Kenichi; Oda, Yoshinao; Taguchi, Tomoaki.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 28, No. 11, 11.2018, p. 1378-1382.

Research output: Contribution to journalArticle

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abstract = "Background: Thoracoscopic surgery for pediatric benign tumors is a common procedure. However, a large incision is needed to remove large tumors from the thoracic cavity. And, for intrapulmonary sequestration in lower lobe, it sometimes needs a large incision to ligate the aberrant vessels. A muscle-sparing axillar skin crease incision (MSASCI) has been introduced for thoracic open surgery, resulting in excellent aesthetic outcomes compared with a standard incision. We herein report the utility of this MSASCI technique in thoracoscopic surgery to remove large tumors from the thoracic cavity and to ligate the aberrant vessels in intrapulmonary sequestration in lower lobe. Materials and Methods: From 2014 April to 2016 March, we performed the MSASCI technique in thoracoscopic surgeries for 5 children. Result: Five cases were diagnosed as mediastinal masses (mature teratoma for 1 case, ganglioneuroblastoma for 2 cases, and extrapulmonary sequestration and intrapulmonary sequestration for 1 case each). The age at surgery was 32.0 ± 25.0 months (range 5-58 months). The size of the mediastinal mass was 9 × 5 × 5 cm, 4 × 3 × 3 cm, 5 × 5 × 2.5 cm, and 3 × 2.5 × 2 cm. For 4 other cases, except for the intrapulmonary sequestration case, the mass was resected under thoracoscopic surgery using only three or four 5-mm trocars and the mass was removed from the thoracic cavity using the MSASCI technique. For the intrapulmonary sequestration case, the aberrant vessels were resected under thoracoscopic surgery using only two 5-mm and one 12-mm trocars and the left lower lobectomy was performed using the MSASCI technique. All lesions were resected completely. No cases had surgical complications, none showed recurrence, and all cases demonstrated good cosmetic outcomes. Conclusions: Performing thoracoscopic surgery using a MSASCI technique is associated with good cosmetic outcome.",
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AU - Obata, Satoshi

AU - Kinoshita, Yoshiaki

AU - Takemoto, Junkichi

AU - Kohashi, Kenichi

AU - Oda, Yoshinao

AU - Taguchi, Tomoaki

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