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Chirurgia 2004 December;17(6):203-8

language: Italian

Bilateral synchronous pulmonary exereses for neoplastic disease using median sternotomy: possibilities and limitations

Politi L., Scanagatta P., Salani A., Montinaro F., Andreani M., Boni D., Crisci C.


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Aim. The effectiveness of median sternotomy in the surgical treatment of neoplastic pulmonary disease, both primary and metastatic has been studied.
Methods. A total of 23 patients who underwent bilateral synchronous exereses using a median sternotomy, from 1985 to 2003 have been analysed.
Results. Results concernig technique, radicality, and survival have been satisfactory. We observed only one case of perioperative (16th day) mortality, due to respiratory failure, in a patient who underwent a bilateral upper lobectomy. Fast recoveries and bearable postoperative pain were observed. Best survivals were obtained for metastases from kidney tumors, treated with bilateral wedge resections (which seem to be the most common procedure).
Conclusion. The conclusion is drawn that median sternotomy is the preferred approach for bilateral, synchronous lung tumor. Some technical problems in the treatment of the lower lobes are solved by staplers. Moreover, the advantages of a single, quick, open operation (preferable to the VATS procedure), with good functional tolerance, should be considered.

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