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

Background: 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.

Methods: Utilizing an illustrative case example, step by step exposure of the lung apex and first rib is provided with the Dartevelle approach.

Results: Safe exposure was provided by this combined transcervical and transthoracic approach.

Conclusions: 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.