Abstracts of the 12th National Congress of the Italian Polyspecialistic Society of Young Surgeons (SPIGC)

✍ Scribed by Crucitti, Antonio

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 195 KB
• Volume: 70
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(1999)70:4+<107::aid-jso14>3.0.co;2-q

✦ Synopsis

Introduction

In pulmonary iterative resections (PIR) performed in management of NSCLC it is important to consider oncological, technical and functional problems to give exact surgical indication: this way it is possible to have satisfactory survival.

Methods

Since 1971 to 1997 in our Division of Thoracic Surgery 71 patients with NSCLC had PIR. 64 were males and 7 females, mean age was 60 ys. 58 had multiple primary lung cancer (MPLC), 7 had local relapse, 5 had stenosis after bronchoplasties and 1 patient had previous benign disease. Operability criteria were: oncological (previous radicality, no metastases, expectation of radical surgery) and functional (cardiopulmonary reserve ).

Results

In our series of double MPLC first operations were 45 lobectomies (L), 9 limited resections (LR) and 2 pneumonectomies (P), while second operations were 21L, 25LR, 9 completion pneumonectomies (CP) and 1P. 2 patients had third tumor.For 7 recurrences first operation consisted in 5L, 1LR and 1P and second operations were 5CP, 1LR and 1 tracheal sleeve. All five PIR for treatment of complications were performed to treat stenosis after bronchoplaties. Patient previously operated witn lobectomy for benign disease was successively treated with CP. The global actuarial 5 ys survival was 38%. The actuarial 5 ys survival in LR was 29.8%, in L 54%, in P and CP 39%. Operative mortality was 3% and complication were 8%.

Discussion and conclusion

In therapy of second primary tumor as well as recurrence an aggressive approach in selected patients can offer good results. The surgical options depend on the extent of the disease, the radicality of initial surgery and the patients pulmonary reserve.