Staged axillary thoracotomy for bilateral lung metastases: an effective and minimally invasive approach
- 作者：Margaritora ; Stefano ; Cesario ; Alfredo ; Galetta ; Domenico ; Kawamukai ; Kenji ; Meacci ; Elisa ; et. al.
- 关键词：Lung metastases ; Surgery ; Axillary thoracotomy ; Muscle sparing
- 刊名：European Journal of Cardio-Thoracic Surgery
- 出版年：1999
- 期刊代码：89_10107940
- 类别：med
- 出版时间：September 1, 1999
- 卷：16
- 期：Supplement 1
- 页码：S37-S39
- 文件大小：67.9 K
摘要
Objective: We describe our experience with the staged axillary thoracotomy (SAT), for the treatment of bilateral lung metastases. Materials and Methods: Between January 1995 and June 1998, 75 lung metastasectomies were carried out in our institution, 49 (65%) monolateral, and 26 (35%) bilateral. In the latter group of patients we adopted a staged axillary thoracotomy. Results: All wedge resections and two lobectomies (1 LUL and 1 RLL) were performed through this approach. Resection has been complete in all patients. Histology was epithelial in 15 (57%), sarcoma in nine (35%) and germ cell in two (8%). Two to three metastases have been resected in 10 patients (38%); four to 10 in 12 patients (46%) and over 10 in four patients (15%). The radiological pre-operative assessment was accurate in 15 patients (57%), underestimated in nine (35%) and overestimated in two (8%). The average interval between the two procedures has been 24±6 days. The average operation duration time was 50 min (range 36–67). We do not report any post-operative death or major complication. The average hospitalization was 3.2 days (range 2–6) for each single procedure and 6.2 days (range 4–10) for both procedures. Conclusion: This technique is adequate, fast and safe and did not affect the shoulder girdle motion at all providing an excellent cosmetic outcome. The operative trauma is limited and a minor post-operative pain is present. A shortening of the interval between the two operations is allowed.