METHOD OF SELECTING SURGICAL APPROACH TO ANTERIOR MEDIASTINUM IN PATIENTS WITH THYMUS TUMORS Russian patent published in 2019 - IPC A61B17/94 A61B6/03 A61K49/04 A61P43/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery and radiation diagnostics, and can be used to select surgical approach to anterior mediastinum in patients with thymus tumors using preoperative computed tomographic angiography of the breast. Division of the mediastinum into the floors is carried out by tomograms in the frontal projection using two conditional vertical lines passing through the sternoclavicular joints, and two conditional horizontal lines passing through V and VIII thoracic vertebrae. If the tumor has a diameter of up to 8 cm in the upper floor of the mediastinum, including a right shift relative to the right sternoclavicular joint, ¹/₂ diameter and more, right-sided thoracoscopic approach is used. If the tumor is localized with diameter of up to 8 cm in the upper floor of the mediastinum with a left shift relative to the left sternoclavicular joint at ¹/₂ diameter and more – left-sided thoracoscopic approach. If the tumor is localized with diameter of up to 8 cm and displaced to the middle floor of mediastinum ¹/₂ diameter and more – video-assisted combined access consisting of sub-xyphoid and transthoracic. If tumor diameter is more than 8 cm in the upper and middle floors of mediastinum without CT signs of invasion of neighboring anatomical structures, right-sided thoracotomy is used in absence of tumor displacement or right- or left-sided thoracotomy depending on tumor displacement to the right or to left on ¹/₂ diameter and more relative to sternoclavicular joints. If observing CT signs of tumor invasion of any diameter in adjacent anatomical structures, combined thoracic sternotomy is used.

EFFECT: method provides reduced duration of surgical intervention, intraoperative blood loss, number of complications, length of hospital stay by visualization of anatomical structures of mediastinum by means of contrast agent, improved scheme of dividing the mediastinum into floors by tomograms in frontal projection.

1 cl, 8 dwg, 1 ex