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General Thoracic and Cardiovascular Surgery

Published in:

01-01-2014 | Original Article

One-stage bilateral pulmonary resections for pulmonary metastases

Authors: Yoshimasa Mizuno, Hisashi Iwata, Koyo Shirahashi, Hirofumi Takemura

Published in: General Thoracic and Cardiovascular Surgery | Issue 1/2014

Abstract

Objective

We analyze the safety and efficacy of one-stage bilateral pulmonary resections for pulmonary metastases via a bilateral approach.

Methods

We retrospectively analyzed 154 cases with pathologically verified pulmonary metastases which underwent curative pulmonary resection. Intraoperative and perioperative variables were evaluated.

Results

One hundred and thirty cases underwent unilateral pulmonary metastasectomy (group U), and the other 24 cases with bilateral pulmonary metastases underwent one-stage bilateral pulmonary resections (group B). Operation time in group B was significantly longer than in group U (354 ± 132 vs. 203 ± 110 min; p < 0.001), but was not longer than double that in group U (407 ± 219 min; p = 0.540). Operative blood loss was not significantly greater in group B than group U (113 ± 158 vs. 76 ± 138 ml; p = 0.069). Neither duration of postoperative hospital stay nor incidence of postoperative complications differed between the two groups. Hospitalization costs in group B were significantly greater than in group U (257 ± 120 × 10⁴ vs. 168 ± 69.2 × 10⁴ yen; p < 0.001), but they were significantly less than double those in group U (336 ± 138 × 10⁴ yen; p < 0.001).

Conclusions

We consider one-stage bilateral pulmonary metastasectomy to be safe for bilateral pulmonary metastases. Moreover, it may offer an economic benefit by avoiding the expenses associated with a two-stage operation.

Thomford NR, Woolner LB, Clagett OT. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg. 1965;49:357–63.PubMed

Kim S, Ott HC, Wright CD, Wain JC, Morse C, Gaissert HA, et al. Pulmonary resection of metastatic sarcoma: prognostic factors associated with improved outcomes. Ann Thorac Surg. 2011;92:1780–6.PubMedCrossRef

García-Yuste M, Cassivi S, Paleru C. The number of pulmonary metastases: influence on practice and outcome. J Thorac Oncol. 2010;5:S161–3.PubMedCrossRef

Rusch VW. Pulmonary metastasectomy. Current indications. Chest. 1995;107:322S–31S.PubMedCrossRef

Internullo E, Cassivi SD, Van Raemdonck D, Friedel G, Treasure T, ESTS Pulmonary Metastasectomy Working Group. Pulmonary metastasectomy: a survey of current practice amongst members of the European Society of Thoracic Surgeons. J Thorac Oncol. 2008;3:1257–66.PubMedCrossRef

Roth JA, Pass HI, Wesley MN, White D, Putnam JB, Seipp C. Comparison of median sternotomy and thoracotomy for resection of pulmonary metastases in patients with adult soft-tissue sarcomas. Ann Thorac Surg. 1986;42:134–8.PubMedCrossRef

Johnston MR. Median sternotomy for resection of pulmonary metastases. J Thorac Cardiovasc Surg. 1983;85:516–22.PubMed

Molnar TF, Gebitekin C, Turna A. What are the considerations in the surgical approach in pulmonary metastasectomy? J Thorac Oncol. 2010;5:S140–4.PubMedCrossRef

Fernández E, Molins L, Fibla JJ, Mier JM. Simultaneous bilateral posterior thoracotomy with the patient in the prone position for resection of bilateral posterior lung metastases. Interact Cardiovasc Thorac Surg. 2011;13:437–9.PubMedCrossRef

10.

Okada M, Sakamoto T, Yuki T, Mimura T, Miyoshi K, Tsubota N. Hybrid surgical approach of video-assisted minithoracotomy for lung cancer: significance of direct visualization on quality of surgery. Chest. 2005;128:2696–701.PubMedCrossRef

11.

Mun M, Kohno T. Single-stage surgical treatment of synchronous bilateral multiple lung cancers. Ann Thorac Surg. 2007;83:1146–51.PubMedCrossRef

12.

Mun M, Kohno T. Efficacy of thoracoscopic resection for multifocal bronchioloalveolar carcinoma showing pure ground-glass opacities of 20 mm or less in diameter. J Thorac Cardiovasc Surg. 2007;134:877–82.PubMedCrossRef

13.

Nakata M, Sawada S, Yamashita M, Saeki H, Kurita A, Takashima S, et al. Surgical treatments for multiple primary adenocarcinoma of the lung. Ann Thorac Surg. 2004;78:1194–9.PubMedCrossRef

14.

Margaritora S, Cesario A, Galetta D, Kawamukai K, Meacci E, Granone P. Staged axillary thoracotomy for bilateral lung metastases: an effective and minimally invasive approach. Eur J Cardiothorac Surg. 1999;16:S37–9.PubMedCrossRef

Title: One-stage bilateral pulmonary resections for pulmonary metastases
Authors: Yoshimasa Mizuno
Hisashi Iwata
Koyo Shirahashi
Hirofumi Takemura
Publication date: 01-01-2014
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 1/2014
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-013-0313-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

One-stage bilateral pulmonary resections for pulmonary metastases

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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