[Developments in surgery of pulmonary metastases]

Two groups of patients between 1977-1986 and 1987-1989 underwent surgery for pulmonary metastases. The most frequent primary sites were the kidney and the colon-rectum. While metastases from testicular cancer have become rare indications, metastases from breast cancer are increasing. Our results show that more metastatic lesions are usually found at operation than indicated by CT scan. The discrepancy amounts to 18% in presumably solitary metastases and increases to 50% if three or more lesions were identified preoperatively. Therefore, bilateral exploration is advocated. Lesions of the posterior lower lobes are more satisfactorily approached by a bilateral transverse incision and sternotomy. The mortality was 1% in the former and 0% in the more recent group of patients.