Original articleGeneral thoracicResection of Pulmonary Metastases From Sarcoma: Can Some Patients Benefit From a Less Invasive Approach?
Section snippets
Patient Selection
From January 2000 to July 2007, 113 consecutive patients underwent curatively intended lung resection for metastatic disease from sarcomas. Patients were selected for surgery if there was no recurrence at the primary site, no other metastastic sites, if all the detected pulmonary nodules were resectable without major functional compromise, and if they had increased in size but not in number during a surveillance period of at least 2 months. Among these 113 patients, we retrospectively
Results
The 31 patients in group TS had a total of 63 operations, 42 by thoracoscopy and 21 by thoracotomy. Staged bilateral resections were performed within less than a month in 11 patients (35%): in 7 patients, one side was treated by thoracoscopy and the other side by thoracotomy; and 4 patients underwent bilateral thoracoscopy. A total of 11 patients in group TS also had at least one resection performed by thoracotomy: in 7 patients before, and in 4 patients after, their thoracoscopic operation.
Comment
Over the past years, several studies have been published on thoracoscopic resection of PM [6, 7, 8, 9]. Video-assisted thoracic surgery has become an accepted modality in patients presenting with a limited number of lesions, usually fewer than two [10]. This attitude is based on lower morbidity after video-assisted thoracic surgery and its encouraging survival rate [7, 11].
However, very few authors have so far recommended a thoracoscopic approach for PM from sarcoma. In three recent series, all
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