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Median sternotomy for resection of bilateral multiple metastatic lung tumors


, : Median sternotomy for resection of bilateral multiple metastatic lung tumors. Journal of the Japanese Association for Thoracic Surgery 36(10): 2255-2262

From January, 1983, to December, 1986, 14 patients with bilateral multiple metastatic tumors of the lung were treated by means of simultaneous bilateral thoractomy under median sternotomy approach. At the same time, 16 patients who had unilateral single or multiple metastases of the lung were treated by lateral thoracotomy. We reviewed our surgical management of these two groups. The following results have been obtained: 1) the number of metastatic lesions and whether the metastases are unilateral or bilateral don't seem to affect the surgical results, 2) the patients with good response to preoperative chemotherapy for lung metastases have better prognosis, 3) tumor markers are useful to prognostic parameters, 4) median sternotomy approach is benefical more than bilateral (synchronous or metachronous) thoracotomy because of lower morbidity and pulmonary complications. We emphasize that unexpected lung metastases are founded occasionaly during thoracotomy of this approach. Moreover, extended surgery such as one-stage operation to lung metastases and primary lesion or retroperitoneal lymph node metastases is possible without surgical risk.

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