[Bilateral thoracotomy in primary lung cancer]

The indication of thoracotomy for double or recurred lung cancer was studied from viewpoints of oncology and performance status. In addition, the mode of operation for unilateral bullous carcinoma in the cases with bilateral giant bullae was discussed. In considering the bilateral thoracotomy for lung cancer, lung volume to be resected must be carefully decided to keep good performance status. It is also necessary to consider the difference of the mode of tumor invasion which frequently depends on the histological type. Factors of indication for bilateral thoracotomy in double or recurred lung cancer are 1) radicality of primary or first lung cancer, 2) no detectable metastatic lesion other than the lung, and 3) good general and cardiopulmonary conditions. As to unilateral lung cancer in the cases with bilateral giant bullae, the first point to be considered is the radicality of lung cancer. And the contralateral giant bulla can be just followed with the observation when it is asymptomatic.