Subsequent pulmonary resection for bronchogenic carcinoma after pneumonectomy

Donington, Jessica S.; Miller, Daniel; Rowland, Charles; Deschamps, Claude; Allen, Mark S.; Trastek, Victor F.; Pairolero, Peter C.

doi:10.1016/s0003-4975(02)03688-3

Cited by 62 publications

(81 citation statements)

References 21 publications

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“…Although there are reports of successful resection on the remaining lung following a previous pneumonectomy, there are no reports of surgery for recurrence in the pneumonectomy space [8]. The question as to whether preoperative histology is required would depend on the accessibility of the lesion for biopsy via bronchoscopy or percutaneous guided biopsy, whilst avoiding the potential risk of seeding tumour cells in the needle tract (as might be anticipated in the second case of recurrent leiomyosarcoma).…”

Section: Discussionmentioning

confidence: 99%

Surgery for tumour recurrence in a pneumonectomy space

Ganti

Milton

Anikin

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Reoperative surgery through a previous pneumonectomy space focuses on the management of postpneumonectomy empyemas and bronchopleural fistulae. There are reports of elective tracheal resections done through the pneumonectomy space. We report two cases of successful excision of recurrent tumours (leiomyosarcoma and carcinoid) performed through the previous pneumonectomy space 2 and 13 years, respectively, after the primary surgical resection. #

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Section: Discussionmentioning

confidence: 99%

Surgery for tumour recurrence in a pneumonectomy space

Ganti

Milton

Anikin

et al. 2006

European Journal of Cardio-Thoracic Surgery

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“…Dans ce cas, la radiothérapie stéréotaxique est également une option thérapeutique face à la chirurgie, d'autant plus que dans ce cas, la question de la préservation de la qualité de vie s'inscrit au premier plan. Les taux de mortalité et de complications postopératoires après chirurgie chez les patients ayant déjà bénéficié antérieurement d'une pneumectomie sont de 8 % et 40 %, respectivement [49]. Une pneumectomie n'est pas une contre-indication à une radiothérapie stéréotaxique [50].…”

Section: Prise En Charge Des Seconds Cancersunclassified

Cancer du poumon : radiothérapie en conditions stéréotaxiques et chirurgie

Antoni¹,

Srour²,

Mornex³

2015

Cancer/Radiothérapie

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“…mediastinoscopy, mediastinotomy, VATS) and/or less invasive (i.e. endobronchial/endo-oesophageal ultrasound guided needle aspiration) preoperative mediastinal investigation procedures to select the appropriate patients who can benefit from second pulmonary resection after pneumonectomy.Although the series contained no additional pulmonary resection other than wedge excision of the tumour, the authors made the statement that 'limited resections should be the method of choice after a pneumonectomy' and support their thesis by a study that retrospectively compared the results of 20 wedge resections, three segmentectomies and one lobectomy performed after pneumonectomy [2]. The recommendation of wedge excision is valid for all small and peripheral tumours existing in a metachronous, synchronous or metastatic fashion on the contralateral lung in a patient who previously underwent a pneumonectomy.…”

mentioning

confidence: 97%

Pulmonary resection after pneumonectomy: preoperative mediastinal assessment and resection method of choice

Halezeroğlu¹

2009

European Journal of Cardio-Thoracic Surgery

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I read with great interest the article of Grodzki et al. [1] on additional pulmonary resection after pneumonectomy. They performed 18 pulmonary wedge resections in a mean of 26 months after a pneumonectomy in patients with non-small cell lung cancer and, reported the long-term survival and functional results. The authors did not perform preoperative invasive mediastinal investigation if there were no enlarged mediastinal lymph nodes on computed tomography (CT) of the patients. Seven patients had metastatic N2 lymph nodes found at thoracotomy and these patients had significantly lower 5-year survival rate when compared to those patients with pathologically proven N0-1 disease (14% vs 63%). Well documented high rate of ipsilateral mediastinal lymph node metastases (39%) and subsequent lower survival rates in patients with metachronous lung cancer with N2 disease in the authors' series obliges the routine use of invasive (i.e. mediastinoscopy, mediastinotomy, VATS) and/or less invasive (i.e. endobronchial/endo-oesophageal ultrasound guided needle aspiration) preoperative mediastinal investigation procedures to select the appropriate patients who can benefit from second pulmonary resection after pneumonectomy.Although the series contained no additional pulmonary resection other than wedge excision of the tumour, the authors made the statement that 'limited resections should be the method of choice after a pneumonectomy' and support their thesis by a study that retrospectively compared the results of 20 wedge resections, three segmentectomies and one lobectomy performed after pneumonectomy [2]. The recommendation of wedge excision is valid for all small and peripheral tumours existing in a metachronous, synchronous or metastatic fashion on the contralateral lung in a patient who previously underwent a pneumonectomy. However, accepting a patient who has no other options but upper or middle lobectomy for the second tumour on the right lung after undergoing left pneumonectomy as unresectable lacks the convincing evidence. In fact, details of the authors' series support the contrast judgment. Eleven patients underwent right and seven patients underwent left pneumonectomy plus wedge resection on the contralateral lung. Of these patients, four had received adjuvant radiotherapy after pneumonectomy (before the wedge resection) and two received radiotherapy after pneumonectomy and wedge resection of the contralateral lung. However, there were no severe postoperative cardiopulmonary complications and only one patient died due to cor pulmonale more than 7 years after the second operation.There are a few case reports documenting the successful results of left pneumonectomy plus right upper or middle lobectomy performed following a careful cardiopulmonary evaluation [3][4][5], as we have observed the similar outcomes in two of our patients one of whom underwent right upper lobectomy and the other underwent middle lobectomy before and after left pneumonectomy, respectively.When observing even a wedge resection of one of the two r...

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Subsequent pulmonary resection for bronchogenic carcinoma after pneumonectomy

Cited by 62 publications

References 21 publications

Surgery for tumour recurrence in a pneumonectomy space

Surgery for tumour recurrence in a pneumonectomy space

Cancer du poumon : radiothérapie en conditions stéréotaxiques et chirurgie

Pulmonary resection after pneumonectomy: preoperative mediastinal assessment and resection method of choice

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