Bilateral thoracotomy for metastatic lung tumor.

概要

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Twenty-nine patients with metastatic lung tumors underwent resection by bilateral thoracotomy. Eleven of them in the early stage underwent staged bilateral thoracotomy and recovered from respiratory insufficiency after a long hospitalization, but died from the disease within 35 months. Eighteen patients in the later stage underwent simultaneous bilateral thoracotomy, and 7 of them underwent lobectomy. However, these 18 patients were free of severe complication irrespective of extensveness of resection ; 10 of them are still alive 5 to 73 months after surgery. These results were no worse than those in patients undergoing unilateral thoracotomy for metastatic lung tumor during the same period. Median sternotomy has the merit of providing quick exposure and closure to minimize operating time and first recovery of pulmonary function. However, there may be a minimal residual lesion if the tumor is located in the posterior aspect of lung. On the other hand, bilateral thoracotomy may result in severe respiratory dysfunction and pain due to extensive destruction of thoracic cage. In the present study, however, these problems were overcome with the use of epidural anesthesia for pain relief.
特定非営利活動法人日本呼吸器外科学会の論文