title: [Results of repeated pulmonary resection in new homolateral neoplastic localization after conservative resection].
abstract: From 1978 through 1992, 93 patients with a previous lobectomy for bronchogenic cancer were referred for homolateral cancer recurrence. Forty-six patients were contraindicated for carcinologic reasons (30 stage IIIb and 16 stage IV). Forty-seven patients (50.5%) were resectable, but 17 did not undergo surgery for associated medical problems (n = 11) or refusal (n = 6). The remaining 30 patients form the population of the present study: 29 males and 1 female; mean age of 61 years (range 47-72). The previous cancer was stage I in 26 and stage II in 4. The mean interval between the 2 cancer diagnoses was 30 months (range 6-97). Three patients underwent an exploratory thoracotomy (10%): 2 had mediastinal involvement and 1 had pleural metastases. Twenty-two (73%) underwent a completion pneumonectomy, and 5 had miscellaneous conservative resections. There were 4 operative deaths (13%): one intraoperative bleeding, 1 postoperative bleeding, 1 pulmonary embolism, 1 pneumonia. Four patients had nonfatal surgical complications: 2 clottings (reexploration), 1 empyema (lavage) and 1 bronchopleural fistula (thoracoplasty). Resected patients were staged as follows: 13 stage I, 4 stage II, 10 stage III. Survival following resection including operative mortality at 3 an 5 years was estimated as 52.5% and 44% for the whole series (72% for stage I). We conclude that repeat surgery conveys an increased risk, but may achieve valuable long-term results.
authors.affiliation: Service de Chirurgie Thoracique, Hôpital Civil, Strasbourg.
authors.forename: G
authors.initials: G
authors.lastname: Massard
authors.forename: G
authors.initials: G
authors.lastname: Lyons
authors.forename: N
authors.initials: N
authors.lastname: Roeslin
authors.forename: R
authors.initials: R
authors.lastname: Kessler
authors.forename: J G
authors.initials: JG
authors.lastname: Hentz
authors.forename: P
authors.initials: P
authors.lastname: Dumont
authors.forename: J M
authors.initials: JM
authors.lastname: Wihlm
authors.forename: G
authors.initials: G
authors.lastname: Morand
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D012086:Reoperation; D013908:Thoracotomy
vernacular_title: Résultats de la chirurgie d'exérèse pulmonaire itérative pour nouvelle localisation néoplasique homolatérale après exérèse conservatrice.