title: Simultaneous Trans-Diaphragmatic Approach for Wedge Resection of the Solitary Ipsilateral Lung Metastasis in Renal Cell Carcinoma.
abstract: About one third of newly diagnosed renal cell carcinoma (RCC) patients present with synchronous metastatic disease. Twenty to 40 % with localized disease at diagnosis eventually develop metastases. Complete metastasectomy confers five year survival rate of 35 % to 50 %. Traditional thoracic approach for lung metastasectomy carries increased morbidity. We report a less morbid trans-diaphragmatic approach. Right cytoreductive nephrectomy with liver and simultaneous trans-diaphragmatic lung resection was performed with uneventful perioperative course in a 60 year male with metastatic RCC. Trans-diaphragmatic resection of peripheral lung metastasis can be considered electively approach in selective cases of RCC with ipsilateral resectable inferior lung metastases.
authors.affiliation: Department of Urology and Kidney Transplant, Sanjay Gandhi Post Graduate Institute of Medical Sciences, 226014, Raebariely, Lucknow, 226014 UP India.
authors.forename: Mittal
authors.initials: M
authors.lastname: Varun
authors.affiliation: Department of Urology and Kidney Transplant, Sanjay Gandhi Post Graduate Institute of Medical Sciences, 226014, Raebariely, Lucknow, 226014 UP India.
authors.forename: Mandhani
authors.initials: M
authors.lastname: Anil
authors.affiliation: Cardiothoracic and Vascular Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, 226014, Raebariely, Lucknow, 226014 UP India.
authors.forename: Gauranga
authors.initials: G
authors.lastname: Majumdar
keywords: Lung metastasis; Radical nephrectomy; Trans-diaphragmatic lung resection