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Impact of resection techniques on postoperative lung function parameters in pulmonary metastasectomy

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Summary

Background

Pulmonary metastasectomy with curative intent is nowadays a common practice in thoracic surgery. The impact of metastasectomy on respiratory function has become a relevant factor in the treatment algorithm of these patients. However, no sufficient data on the loss of lung function following pulmonary metastasectomy is available to date.

Methods

A prospective single center study was designed to determine changes in lung function parameters in patients undergoing metastasectomy. Forty-five consecutive patients were included in the study. In 19 patients, metastases were removed by enucleation (laser = 10; electrocautery = 9), in 19 patients by wedge resection, and 7 patients received a lobectomy in order to achieve clear resection margins. Lung function testing was obtained from all patients preoperatively and 3 months after hospital discharge.

Results

A significant decrease in FEV1 and VC was found when comparing enucleation/wedge/lobectomy patients (FEV1: 3.4 ± 0.7, 7.6 ± 1.5, 14.2 ± 3.0; VC: 2.4 ± 1.6, 4.7 ± 1.6, 16.9 ± 2.9; respectively). However, no differences were found regarding the loss of FEV1 per resected nodule between laser and electrocautery enucleations. These findings were confirmed by a volumetric analysis of the resected tissue and did not correlate with size of metastases as determined by preoperative CT evaluations.

Conclusions

The surgical resection of pulmonary metastases is associated with a detectable but mild loss of lung function. Lung parenchyma sparing resection methods—e.g. electrocautery or laser enucleations—should be preferred over less tissue-sparing techniques.

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Conflict of interest

The authors declare that there are no actual or potential conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    K. Hoetzenecker MD, T. Schweiger, C. Nikolowsky, L. Lehmann, H. J. Ankersmit MD, W. Klepetko MD & G. Lang MD

  2. Department of Radiology, Medical University of Vienna, Vienna, Austria

    F. Gittler MD

Authors
  1. K. Hoetzenecker MD
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  2. T. Schweiger
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  3. C. Nikolowsky
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  4. L. Lehmann
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  5. F. Gittler MD
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  6. H. J. Ankersmit MD
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  7. W. Klepetko MD
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  8. G. Lang MD
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Correspondence to K. Hoetzenecker MD.

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Hoetzenecker, K., Schweiger, T., Nikolowsky, C. et al. Impact of resection techniques on postoperative lung function parameters in pulmonary metastasectomy. Eur Surg 45, 93–97 (2013). https://doi.org/10.1007/s10353-013-0202-3

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  • DOI: https://doi.org/10.1007/s10353-013-0202-3

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