Voies d'abord chirurgicales cervicothoraciques

Abstract

As complex it is, good knowledge of anatomy is mandatory before performing surgical approach of the cervico-thoracic area. In this chapter, the authors describe the detailed gesture to perform surgical cervico-thoracic approaches and propose a synthesis of the different advances published in that matter. The cervico-thoracic approach of Cormier-Dartevelle-Grunenwald, the cervico-manubrial approach, the two combined video-assisted mediastinoscopy and thoracoscopy approaches are described. Selecting the better approach should take into account the situation of planned surgery or emergency, the need for combined access of both cervical and mediastinal or axillary regions or 2-stage approaches. Any of such approaches allows combined access of the three cervical, axillary, and thoraco-mediastinal regions. Such approaches are sometimes more time-consuming than the planned surgery act itself and they need thoracic surgery expertise. The thoracic outlet syndrome is not considered.