Which of the following is a standard surgical approach to access a mediastinal mass?

• A. Median sternotomy
• B. Laparotomy
• C. Craniotomy
• D. Lateral leg amputation

Answer: (A)

To access a mediastinal mass, a central chest approach that provides wide, controlled exposure to all mediastinal compartments is used. Median sternotomy opens the chest along the midline by splitting the sternum, which gives direct access to anterior, middle, and even posterior mediastinal structures, including the thymus, pericardium, trachea, esophagus, and the major vessels. It also allows rapid control of bleeding and, if needed, cannulation for cardiopulmonary bypass when the mass involves or is adjacent to critical cardiovascular structures.

Laparotomy opens the abdominal cavity and does not reach the mediastinum; craniotomy targets the skull and is unrelated to thoracic access; a lateral leg amputation obviously addresses a lower limb issue.