A logical approach to the thoracic inlet: the Dartevelle approach revisited.

Abstract

Traditionally, Pancoast tumors have been associated with an extremely poor outlook. Recently, Dartevelle and colleagues have noted a significant survival advantage in patients treated by wide en bloc excision. Utilizing an illustrative case example, step by step exposure of the lung apex and first rib is provided with the Dartevelle approach. Safe exposure was provided by this combined transcervical and transthoracic approach. The Dartevelle approach appears to be the favored approach to anterior lung apex or first rib lesions. The combined efforts of an Otolaryngolist-Head and Neck Surgeon and a Thoracic Surgeon may allow for safe, wide en bloc excision of these otherwise difficult to access lesions.