Document Detail


Transxiphoid video-assisted pulmonary metastasectomy: relevance of helical computed tomography occult lesions.
MedLine Citation:
PMID:  11156082     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The new transxiphoid video-assisted approach allows manual palpation of both lungs, thus permitting better evaluation of helical computed tomography (CT) in detection of pulmonary metastases. METHODS: From December 1995 to May 1999, 22 patients underwent a transxiphoid video-assisted pulmonary metastasectomy. Manual palpation of both lungs was possible in 18 patients, whereas only 13 had radiologic evidence of unilateral disease. Primaries were colon-rectum (n = 8), kidney (n = 3), uterus (n = 2), larynx (n = 2), limb osteosarcoma (n = 2), and one each of breast, skin melanoma, prostate, fibrosarcoma, and ovary. RESULTS: No perioperative death occurred. Fifty-eight lesions, 49 metastatic, were resected, whereas only 46 had been predicted by helical CT scan. Twelve occult lesions were discovered, eight of which were malignant. Overall sensitivity for proved metastases was 83.7% (41 of 49) and 75.8% (22 of 29) for those less than or equal to 5 mm. Mean follow-up was 15.27 months. Only 2 patients had pulmonary relapse at 6 and 12 months. CONCLUSIONS: Despite helical CT, occult metastases may still be identified in almost one-third of the patients. The transxiphoid approach allows routine bilateral palpation and safe resection, and overcomes this critical limitation of video-assisted metastasectomy.
Authors:
V Ambrogi; M Paci; E Pompeo; T C Mineo
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  70     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-01-11     Completed Date:  2001-02-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1847-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic Surgery, Tor Vergata University, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Disease-Free Survival
Female
Follow-Up Studies
Humans
Lung Neoplasms / radiography,  secondary*,  surgery
Male
Middle Aged
Pneumonectomy
Predictive Value of Tests
Reoperation
Thoracic Surgery, Video-Assisted*
Tomography, X-Ray Computed*

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