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.
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References
Thomford NR, Woolner LB, Clagett OT. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg. 1965;49:357–63.
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.
García-Yuste M, Cassivi S, Paleru C. The number of pulmonary metastases: influence on practice and outcome. J Thorac Oncol. 2010;5:S161–3.
Rusch VW. Pulmonary metastasectomy. Current indications. Chest. 1995;107:322S–31S.
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.
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.
Johnston MR. Median sternotomy for resection of pulmonary metastases. J Thorac Cardiovasc Surg. 1983;85:516–22.
Molnar TF, Gebitekin C, Turna A. What are the considerations in the surgical approach in pulmonary metastasectomy? J Thorac Oncol. 2010;5:S140–4.
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.
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.
Mun M, Kohno T. Single-stage surgical treatment of synchronous bilateral multiple lung cancers. Ann Thorac Surg. 2007;83:1146–51.
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.
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.
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.
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Yoshimasa Mizuno and other co-authors have no conflict of interest.
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Mizuno, Y., Iwata, H., Shirahashi, K. et al. One-stage bilateral pulmonary resections for pulmonary metastases. Gen Thorac Cardiovasc Surg 62, 53–57 (2014). https://doi.org/10.1007/s11748-013-0313-6
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DOI: https://doi.org/10.1007/s11748-013-0313-6