Intrapericardial approach via median sternotomy for hilar non-small cell lung cancer invading the main pulmonary artery.

We describe a successful resection of the main pulmonary artery (MPA) using an intrapericardial approach via a median sternotomy in a patient with large hilar non-small cell lung cancer (NSCLC) invading the left MPA and Botallo's ligament. This approach was able to provide a good operative view even for the large hilar tumor, with easier and safer resection of the MPA, unlike the anteroaxial or posterolateral approach. This approach is a useful option for easy, safe and complete surgical resection in patients with NSCLC invading the MPA.