Combined liver and lung metastasectomy through an exclusive transthoracic approach.
BACKGROUND
In a very selected group of patients, resection of metachronous liver and lung metastases, prolongs survival despite the aggressive nature of these lesions. We present here our experience with metastasectomy in patients with metachronous liver and lung metastases in whom, an exclusive transthoracic approach was performed.


METHODS
Between 2002 and 2005, five patients with metachronous colorectal liver and right-lung metastases, underwent an exclusive transthoracic approach. There were three men and two women, with a median age of 68 years (range, 55-76 years). Liver resections performed included segmentectomy of segments VII, VIII, or both. Previous operations include colon resection, adhesiolysis, or ventral hernia repair were performed in all patients.


RESULTS
No mortality was documented. Morbidity included pleural effusion (n = 2) and post-operative pneumonia (n = 1) which responded to conservative management. Median hospital stay was 8 days (range 5-12 days). With a median follow-up of 26 months all patients are alive without recurrent disease.


CONCLUSIONS
An aggressive surgical approach should be undertaken for CRC metastases. An exclusive transthoracic approach is feasible for combined lung and subdiaphragmatic liver metastasectomy in selected cases with previous abdominal surgery.
Delis
Spiros G
SG
1st Surgical Department, Liver Surgical Unit, Agia Olga Hospital, Athens, Greece.
Madariaga
Juan
J
Bakoyiannis
Andreas
A
Avgerinos
Costas
C
Touloumis
Zisis
Z
Vasileios
Vasiliadis
V
Dervenis
Christos
C
D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D003964:Diaphragm / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D019616:Thoracic Surgical Procedures / Q000379:methods*