PURPOSE: The use of repeated pulmonary resection for metachronous pulmonary metastasis has increased. We assessed whether video-assisted thoracic surgery (VATS) produced greater benefits than classic thoracotomy for repeated pulmonary metastasectomy procedures. METHODS: A total of 46 patients who had undergone two or more pulmonary metastasectomies from 1995 to 2008 were analyzed in this study. These patients were classified into four groups as follows: group A (previous VATS/present VATS); group B (previous VATS/present thoracotomy); group C (previous thoracotomy/present VATS); group D (previous thoracotomy/present thoracotomy). The clinical features of these four groups were then compared. RESULTS: The operating time and the duration of thoracic drainage were longer in group D than in group A or B. The operating time was also longer in group C than in group A. Intraoperative bleeding was greater in group D patients than in other three groups. There were no discernible morbidities resulting from VATS in groups A or C. No differences were found in the occurrence of relapse among the groups. The mean interval from the previous to the present pulmonary metastasectomy also did not differ significantly among groups. CONCLUSION: VATS can result in a shortened operating time, reduced intraoperative bleeding, and generally fewer complications compared with repeated classic thoracotomy. VATS is also potentially a curative procedure as it is not inferior to classic thoracotomy in terms of the relapse rate after repeated pulmonary metastasectomy.
PURPOSE: The use of repeated pulmonary resection for metachronous pulmonary metastasis has increased. We assessed whether video-assisted thoracic surgery (VATS) produced greater benefits than classic thoracotomy for repeated pulmonary metastasectomy procedures. METHODS: A total of 46 patients who had undergone two or more pulmonary metastasectomies from 1995 to 2008 were analyzed in this study. These patients were classified into four groups as follows: group A (previous VATS/present VATS); group B (previous VATS/present thoracotomy); group C (previous thoracotomy/present VATS); group D (previous thoracotomy/present thoracotomy). The clinical features of these four groups were then compared. RESULTS: The operating time and the duration of thoracic drainage were longer in group D than in group A or B. The operating time was also longer in group C than in group A. Intraoperative bleeding was greater in group D patients than in other three groups. There were no discernible morbidities resulting from VATS in groups A or C. No differences were found in the occurrence of relapse among the groups. The mean interval from the previous to the present pulmonary metastasectomy also did not differ significantly among groups. CONCLUSION: VATS can result in a shortened operating time, reduced intraoperative bleeding, and generally fewer complications compared with repeated classic thoracotomy. VATS is also potentially a curative procedure as it is not inferior to classic thoracotomy in terms of the relapse rate after repeated pulmonary metastasectomy.
Authors: R J Landreneau; T De Giacomo; M J Mack; S R Hazelrigg; P F Ferson; R J Keenan; J D Luketich; A P Yim; G F Coloni Journal: Eur J Cardiothorac Surg Date: 2000-12 Impact factor: 4.191
Authors: J C Lin; R J Wiechmann; M F Szwerc; S R Hazelrigg; P F Ferson; K S Naunheim; R J Keenan; A P Yim; E Rendina; T DeGiacomo; G F Coloni; F Venuta; R S Macherey; S Bartley; R J Landreneau Journal: Surgery Date: 1999-10 Impact factor: 3.982
Authors: Alden M Parsons; Erin K Ennis; Bonnie C Yankaskas; Leonard A Parker; W Brian Hyslop; Frank C Detterbeck Journal: Ann Thorac Surg Date: 2007-12 Impact factor: 4.330
Authors: S R Hazelrigg; S K Nunchuck; R J Landreneau; M J Mack; K S Naunheim; P E Seifert; J E Auer Journal: Ann Thorac Surg Date: 1993-09 Impact factor: 4.330