Transaxillary thoracotomy revisited.

Abstract

Transaxillary thoracotomy is a well-known but underused approach to both benign and malignant conditions in the chest. The traditional posterolateral thoracotomy affords little advantage over this incision in terms of staging of disease or therapeutic resection. Previous reports have emphasized the wide range of conditions for which this approach is suitable, but advances in the technique and design of stapling devices and routine use of the double-lumen endotracheal tube have further enhanced its indications. We have reviewed 54 consecutive patients who have undergone transaxillary thoracotomy over a 2 1/2-year period. The wide range of procedures performed up to and including pneumonectomy indicates the versatility of the approach. We now consider transaxillary thoracotomy to be the incision of choice for most pulmonary and mediastinal lesions and an attractive alternative to mediastinoscopy for the identification and staging of chest tumors.