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[Reoperations in lung surgery].

G Montesano1, A G Nasti, A M Angelici

  • 1IVa Clinica Chirurgica Generale e Toracica Dipartimento di Scienze Chirurgiche e Tecnologie Mediche Applicate Francesco Durante Università degli Studi di Roma La Sapienza.

Annali Italiani Di Chirurgia
|August 29, 2002
PubMed
Summary
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Second thoracotomy addresses urgent complications or late-stage lung tumors after initial chest surgery. Procedures like completion pneumonectomy are complex but vital for patient outcomes.

Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Oncology

Background:

  • Reoperations after chest surgery address immediate complications or late-stage issues.
  • Late reoperations may involve treating complications, second primary lung tumors (SPLTs), or metastases.

Purpose of the Study:

  • To review the indications and outcomes of various second thoracotomy procedures.
  • To highlight the complexities and mortality associated with specific reoperative surgeries.

Main Methods:

  • Review of clinical experience with different types of reoperative chest surgeries.
  • Analysis of indications for procedures such as completion pneumonectomy, exploratory thoracotomy, and Abruzzini's operation.

Main Results:

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  • Completion pneumonectomy is indicated for residual lobe non-expansion, fistulas, or new ipsilateral lung tumors, carrying significant technical challenges and mortality.
  • Less complex procedures include second ipsilateral thoracotomy for exploration or resection and contralateral resections.
  • Abruzzini's operation for primary bronchus fistulas, while complex, showed good results with low mortality in 15 cases.

    • Conclusions:

    • Second thoracotomies encompass a range of procedures with varying complexity and indications.
    • Careful consideration of surgical approach is crucial for managing complications and secondary lung conditions after initial chest surgery.