title: Hand-assisted thoracoscopic surgery for pulmonary metastasectomy through sternocostal triangle access: superiority in detection of non-imaged pulmonary nodules.
abstract: 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.
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China [3].
authors.forename: Long
authors.initials: L
authors.lastname: Hao
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China [3].
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China [3].
authors.forename: Lin
authors.initials: L
authors.lastname: YongBin
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China.
authors.forename: Situ
authors.initials: S
authors.lastname: DongRong
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yan
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: YiGong
authors.affiliation: 1] Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou [2] Lung Cancer Institute of Sun Yat-sen University, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China.
authors.forename: Ma
authors.initials: M
authors.lastname: GuoWei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D049268:Positron-Emission Tomography; D003074:Solitary Pulmonary Nodule / Q000473:pathology; D013906:Thoracoscopy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult