Introduction:The surgical therapy of selected secondary pulmonary tumors, including both solitary and multiple or bilateral tumours, is currently a generally accepted therapeutic procedure demonstrably extending the long term survival of these patients. Purpose: The purpose of the present study is a ten-year retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors. Methods: In 2000-2009, 87 patients (of which 44 were male with a median age of 64 years) with secondary pulmonary tumors underwent surgery at the departments of the authors of this study. Solitary metastases were found in 60 patients, multiple metastases in the remaining patients, while 13 patients had bilateral metastases. The median disease-free period from surgery of the primary tumor was 31 months. Results: In total, 74 unilateral and 13 bilateral surgeries were performed in one or two periods. The most common type of surgery included anatomical pulmonary resections (32 procedures), wedge resections (29 procedures) and laser excisions (24 procedures). In total, the radical resection was performed in 156 metastases. Post-operative morbidity was 17.2 % with zero mortality. A proportion of 50.6 % of operated patients survived after resection of metastases with median survival of 39 months. The overall three-year and fi ve-year survivals in the group were 57 % and 38 %, respectively. A proportion of 35.6 % of patients live after resection of metastases without disease progression, and the median is 15 months. Conclusion:The achieved results confi rm the positive role of pulmonary metastasectomy in the therapy of disseminated cancer disease (Tab. 1, Fig. 5, Ref. 34 Hematogeneous pulmonary metastases are generally considered as a sign of advanced generalization of malignant disease. Up to one third of malignant tumors have pulmonary metastases, and in most of them the lungs are even the fi rst site of dissemination. Nevertheless, in a signifi cant number of patients, the pulmonary affl iction is stopped or eliminated during the dissemination of metastases, and these patients may benefi t from radical resection of metastases (1, 2). Surgical therapy of the selected secondary pulmonary tumors, not only solitary but also multiple or bilateral, is today generally the accepted therapeutic procedure which demonstrably extends long term survival of these patients with acceptable peri-operative morbidity and mortality. The purpose of the following study is a retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors over a period of ten years. Material and methodsIn 2000-2009 we performed surgery on 87 patients with secondary pulmonary tumors. Only patients who had undergone a radical resection of the primary tumor, were free from other extrapulmonary metastases, their pulmonary metastases appeared to be radically removable according to the pre-operative examinations as for the number and location, and the benefi t of surgery...
Sequestration is defined as an area of abnormal pulmonary tissue not connected with the bronchial tree, supplied by an aberrant systemic artery and without a normal pulmonary function. Extralobar (ELS) and intralobar (ILS) forms are distinguished. During the year 2002 the authors diagnosed and operated upon two cases of the intralobar form of pulmonary sequestration, and in last 25 years five cases - 4 x ILS and 1 x ELS. Reported are a 35 year old man with relapsing infections of the sequester and a 21 year old woman where the sequestration was accidentally found without clinical symptoms. The focus was localized in both cases in the left lower lobe of the lungs, anomalous supply arteries derived from the thoracic aorta. Venous drainage of the sequester was different - in the man a systemic drainage via the v. azygos, in the woman via the pulmonary veins was found. In one case the diagnosis was made on the basis of angiography and computer tomography, in the other case it was made on the basis of multidetector CT angiography (MDCTA). Both findings were treated by primary surgical intervention lobectomy. The postoperative course was uneventful.
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