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Pulmonary metastasectomy: outcomes and issues according to the type of surgical resection

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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.

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  1. Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Masahiko Higashiyama, Toshiteru Tokunaga, Tomoyuki Nakagiri, Daisuke Ishida, Hidenori Kuno & Jiro Okami

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  1. Masahiko Higashiyama
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  2. Toshiteru Tokunaga
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Correspondence to Masahiko Higashiyama.

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Higashiyama, M., Tokunaga, T., Nakagiri, T. et al. Pulmonary metastasectomy: outcomes and issues according to the type of surgical resection. Gen Thorac Cardiovasc Surg 63, 320–330 (2015). https://doi.org/10.1007/s11748-015-0544-9

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