Hand-Assisted Thoracoscopic Surgery for Bilateral Lung Metastasectomy Through Sternocostal Triangle Access

Long, Hao; Zheng, Yan; Situ, Dongrong; Ma, Guowei; Lin, Zhichao; Wang, Jinfeng

doi:10.1016/j.athoracsur.2010.11.057

Cited by 16 publications

(13 citation statements)

References 26 publications

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“…These studies also demonstrated that the sensitivity of PET-CT varies from 64.3% to 67.5% (Table 5)132021, while our figure was 66%. The above results demonstrated that our HATS procedure, which may be more minimally invasive compared with sternotomy or thoracotomy6, had similar ability in detection of occult pulmonary metastases.…”

Section: Discussionmentioning

confidence: 53%

“…In conclusion, our HATS approach provides an easier way for routine bilateral pleural exploration similar to conventional sternotomy or thoracotomy regardless of unilateral or bilateral nodules on preoperative radiographic imaging6. Using this HATS approach, we detected and removed occult pulmonary metastases, which might contribute to long-term DFS.…”

Section: Discussionmentioning

confidence: 85%

“…Under this circumstance, the HATS procedure, which allows bilateral pleural exploration with a hand, would be an appropriate technique for patients undergoing metastasectomy with curative intent3456. Mineo, Wright and Detterbeck have reported their HATS approaches that allow bilateral manual palpation of the lung in 1999, 2003 and 2004, respectively345.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the change of resection from xiphoid appendix to sternocostal triangle access reduced the morbidity of intraoperative rhythm disturbance. Furthermore, keeping the integrity of diaphragm may reduce the risk of post-operative diaphragmatic hernia6.…”

Section: Discussionmentioning

confidence: 99%

“…Some new approaches, such as the transxiphoid hand-assisted thoracoscopic surgery (HATS) developed by Mineo3 and Detterbeck4 as well as the trans-diaphragmatic HATS developed by Wright5, have been used in this field. We also developed a HATS procedure for bilateral lung metastasectomy through sternocostal triangle access, which has been reported previously6.…”

mentioning

confidence: 99%

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Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Long

Jiang

Yong-bin

et al. 2014

Sci Rep

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Hand-Assisted Thoracoscopic Surgery for pulmonary metastasectomy through sternocostal triangle access allows manual palpation of both lungs, thus permitting effective treatment of lung metastases. In our research, 62 patients from November 2001 to January 2012 underwent our Hand-Assisted Thoracoscopic Surgery procedures for pulmonary metastasectomy. Clinical data, including the number of pulmonary metastases determined by Computed Tomography/Positron Emission Tomography-Computed Tomography, surgical findings and survival data of these patients were collected. We found that the median follow-up time was 23.7 months (range 2.4 to 85.6 months). 30 cases of them had post-operative recurrences and the median disease-free survival period was 27.4 months. For Computed Tomography scan, the overall sensitivity for proved metastases was 63% (115/182). 67 non-imaged malignant nodules were palpated and removed in 14 cases. For Positron Emission Tomography-Computed Tomography scan, the overall sensitivity was 66% (79/120). 41 non-imaged malignant nodules were palpated and removed in 12 cases. This study show that the Hand-Assisted Thoracoscopic Surgery provides an easier way for routine bilateral pleural exploration, and thus is critical and effective in detection of non-imaged malignant pulmonary metastases, which might contribute to long-term disease-free survival.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Long

Jiang

Yong-bin

et al. 2014

Sci Rep

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Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

Londero

Morelli

Parise

et al. 2019

Journal of Surgical Oncology

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Background and Objectives: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice. Methods: One hundred eighty‐one patients undergoing a first PM were studied. Eighty‐six patients (47.5%) underwent lymphadenectomy (L+ group) whereas 95 (52.5%) did not undergo nodal harvesting (L−group). Main outcomes were overall survival (OS) and disease‐free survival (DFS). Median follow‐up was 25 months (interquartile range [IQR], 13‐49). Results: At follow‐up 84 patients (46.4%) died, whereas 97 (53.6%) were still alive with recurrence in 78 patients (43%). There was no difference in 5‐year survival (L+ 30.0% vs L− 43.2%; P = .87) or in the 5‐year cumulative incidence of recurrence (L + 63.2% vs L−80%; P = .07) between the two groups. Multivariable analysis indicated that disease‐free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non‐small–cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11‐fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence. Conclusion: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.

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Thoracoscopic-Laparoscopic Ivor Lewis-McKeown Esophagectomy

Zhang

Zou

Duan

et al. 2018

Atlas of Thoracoscopic-Lapacoscopic Esophagectomy

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Hand-Assisted Thoracoscopic Surgery for Bilateral Lung Metastasectomy Through Sternocostal Triangle Access

Cited by 16 publications

References 26 publications

Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

Thoracoscopic-Laparoscopic Ivor Lewis-McKeown Esophagectomy

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