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Başlık: What are the considerations in the surgical approach in pulmonary metastasectomy?
Yazarlar: Molnar, Tamas F.
Turna, Akif
Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.
Gebitekin, Cengiz
6602156436
Anahtar kelimeler: Asissted thoracic-surgery
Median sternotomy
Computed-tomography
Lung metastasectomy
Resection
Palpation
Thoracotomy
Lesions
Dissemination
Incision
Oncology
Respiratory system
Yayın Tarihi: Haz-2010
Yayıncı: Elsevier
Atıf: Molnar, T. F. vd. (2010). "What are the considerations in the surgical approach in pulmonary metastasectomy?". Journal of Thoracic Oncology, 5(6), 140-144.
Özet: There are four matters of uncertainty considered in this working group report, which are distilled into four clinical questions: (1) What is the evidence for the need for palpation of the lung in modern era of imaging? (2) Is there evidence of a difference in outcome for an open versus a closed approach? (3) Is there evidence of a difference in outcome for an initial policy of bilateral versus unilateral exploration? (4) In patients with known bilateral disease, is there a difference in outcome with a simultaneous versus a staged approach? We searched the literature formally and supplemented this with knowledge from all other sources. We provide evidence tables on the first two questions by relying on a group consensus and frame recommendations for the other two. There are no randomized trials to guide us but there are comparative studies addressing the need for palpation and the need to and open operation in all cases. The evidence is equivocal, and opinions are divided in the literature. Palpation of the lung is still seen as necessary in a therapeutic metastasectomy as opposed to a diagnostic procedure when videothoracoscopy is adequate. However, the importance of palpation becomes less clear with advances in imaging. Routine bilateral exploration for unilateral disease was not favored. For bilateral disease, an initial median sternotomy has a place for some cases but sequenced thoracotomy was preferred.
URI: https://doi.org/10.1097/JTO.0b013e3181dcf62c
https://pubmed.ncbi.nlm.nih.gov/20502249/
http://hdl.handle.net/11452/22768
ISSN: 1556-0864
Koleksiyonlarda Görünür:Scopus
Web of Science

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