Bilateral pulmonary metastasectomy through right thoracotomy.

Bilateral thoracotomies spaced at least 4 weeks apart are often required for the resection of bilateral pulmonary metastases. The anatomic distribution of the metastatic disease may rarely permit excision of bilateral pulmonary deposits through one thoracotomy incision. We demonstrate a successful bilateral pulmonary metastasectomy in the right upper lobe, right middle lobe, and left upper lobe through a right thoracotomy in a 40-year-old man with a past history of rectal adenocarcinoma and of left open pulmonary metastasectomy 1 year previously. The left upper lobe was approached by opening the pleura anterior to the ascending aorta.