title: Combined liver and lung metastasectomy through an exclusive transthoracic approach.
abstract: 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.
authors: 1st Surgical Department, Liver Surgical Unit, Agia Olga Hospital, Athens, Greece.
authors: Spiros G
authors: SG
authors: Delis
authors: Juan
authors: J
authors: Madariaga
authors: Andreas
authors: A
authors: Bakoyiannis
authors: Costas
authors: C
authors: Avgerinos
authors: Zisis
authors: Z
authors: Touloumis
authors: Vasiliadis
authors: V
authors: Vasileios
authors: Christos
authors: C
authors: Dervenis
mesh_terms: 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*