title: Pulmonary metastasectomy: outcomes and issues according to the type of surgical resection.
abstract: According to a recent report by the Committee for Scientific Affairs of the Japanese Association for Thoracic Surgery, pulmonary metastasectomy accounted for as many as 10.2 % of all entry cases of general thoracic surgery, and its use is increasing year by year. Accordingly, many studies have examined the surgical procedures used during pulmonary metastasectomy for metastases from primary tumors affecting various organs as well as the outcomes of and indications for such procedures, but some problems remain. In this article, the following questions related to the surgical approach and the type of resection used during pulmonary metastasectomy are reviewed: (1) Wedge resection--what is a safe margin for preventing local recurrence? (2) What is the clinical significance of node sampling/dissection during pulmonary metastasectomy? and (3) When is segmentectomy necessary? In addition, we discuss: (4) open thoracotomy vs. video-assisted thoracoscopic surgery (VATS), (5) repeated metastasectomy for pulmonary metastases, (6) the surgical approach for bilateral pulmonary metastasectomy, (7) pneumonectomy, and (8) pulmonary metastasectomy combined with resection of the neighboring organs.
authors.affiliation: Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan, higasiyama-ma@mc.pref.osaka.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakagiri
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ishida
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kuno
authors.forename: Jiro
authors.initials: J
authors.lastname: Okami
mesh_terms: D004867:Equipment Design; D006801:Humans; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D059146:Metastasectomy / Q000295:instrumentation / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000601:surgery; D011013:Pneumonectomy / Q000295:instrumentation / Q000379:methods; D012086:Reoperation; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D013908:Thoracotomy / Q000295:instrumentation / Q000379:methods
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