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[Lung resection after pneumonectomy for bronchogenic carcinoma]
1Divisione di Chirurgia Toracica, Ospedale Maggiore, Azienda Ospedaliera, Verona.
Minerva Chirurgica
|August 14, 1998
Summary
Patients who have had one lung removed (pneumonectomy) can undergo further lung cancer surgery. Careful cardiopulmonary evaluation is key for successful contralateral resections in single-lung patients.
Area of Science:
- Thoracic Surgery
- Oncology
- Pulmonary Medicine
Context:
- Lung cancer management often involves surgical resection.
- Metachronous contralateral lung cancers can occur after initial pneumonectomy.
- Assessing operability in patients with compromised pulmonary function is challenging.
Purpose:
- To evaluate the feasibility and outcomes of contralateral lung resection in patients with a history of pneumonectomy for lung cancer.
- To determine appropriate functional evaluation methods for these high-risk patients.
Summary:
- Four patients with prior pneumonectomy underwent contralateral resection for metachronous lung cancer.
- Standard functional evaluations (ECG, spirometry, blood gas analysis) were used, with advanced techniques in select cases.
- Methods included femoro-femoral bypass and High Frequency Jet Ventilation.
- No operative complications or mortality were observed.
- Two patients survived disease-free; two succumbed to metastatic disease.
Impact:
- Contralateral lung resection is a viable option for selected patients with a single lung.
- Routine cardiopulmonary evaluation may suffice, but advanced testing is recommended when operability is uncertain.
- Mediastinoscopy is advised for staging, even with minimally enlarged nodes on CT, due to high operative risk.