[Exploratory thoracotomy: causes of inoperability of non-small-cell lung cancer]

The investigation is concerned with evaluation of different procedures of preoperative examination as well as reasons for carrying out explorative thoracotomy for lung cancer. The data on examination and surgical treatment of 81 patients who underwent explorative thoracotomy for primary non-small cell cancer of the lung were analyzed. The procedure was performed in 9.3% of surgical patients. Assessment of preoperative clinical and macro- and microscopic findings as well as resected material was carried out for each patient. The X-ray, bronchological, functional, angiographic and computed tomography evidence identified involvement of the mediastinal systems (pulmonary artery, vena cava superior, myocardium, aorta and trachea) and dissemination of tumor to the pleura as the most common cause of inoperability. Radical surgery was contraindicated in 65% because of the involvement of several organs and tissues. In certain situations, explorative thoracotomy should be resorted to as the last method of diagnosis of primary lung cancer.