ArticleYonsei medical journal2023
A Comparative Study of a Sternum-Sparing Procedure and Clamshell Incision in Bilateral Lung Transplantation.
Article in Yonsei medical journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Sternal Complications After Clamshell Surgery for (Heart-)Lung Transplantation-A Systematic Literature Review.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Pooled it
- Sternal Closure After Clamshell Thoracotomy for Bilateral Lung Transplantation: Comparison Between Different Techniques.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Anterolateral vs. Clamshell Thoracotomy for Bilateral Lung Transplantation.Clinical transplantation · 2025Article
- Reducing Upper Extremity Precautions After Lung Transplant: The Clamshell Protocol Pilot Study.Cardiopulmonary physical therapy journal · 2025Article
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Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
purposeClamshell incision offers excellent exposure and access to the pleural spaces and is a standard incision for lung transplantation. However, due to its high sternal complication rate, the clamshell incision is considered a procedure that requires improvement. In this study, we aimed to investigate the outcomes of transverse sternotomy with clamshell incision in comparison to sternum-sparing bilateral anterolateral thoracotomy (BAT). MATERIALS AND
methodsIn total, 134 bilateral sequential lung transplants were performed from May 2013 to June 2022. The clamshell incision was used between May 2013 and December 2017, and the BAT was introduced in January 2018. Thirty-four patients underwent clamshell surgery, and 100 patients underwent BAT. We retrospectively compared patient characteristics and perioperative and postoperative outcomes between the two groups.
resultsThe clamshell group required an operation time of 745.18±101.76 min, which was significantly longer than that of the BAT group at 669.90±134.09 min (
conclusionLess-invasive lung transplantation via sternum-sparing BAT is a safe procedure with low morbidity and favorable outcomes. Preventing sternal instability enables more stable breathing after surgery, earlier weaning from mechanical ventilation, and faster recovery to routine activities.
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