Skip to main content
SpringerLink
Log in

Pulmonary Resections in the Extensive Pulmonary Pathology

  • Chapter
  • First Online:
Book cover Thoracic Surgery

  • 1964 Accesses

Abstract

The philosophy that radical surgical resection of all neoplastic tissue can be curative, even for extended lesions, has widely conditioned the therapeutic thinking of surgeons at the beginning of surgery and, to some degree, still remains alive in many surgeons at present. Complete tumor removal is the target of any surgical excision when treating lung tumors and extended resections to structures contiguous to the lungs—as chest wall, vertebrae, diaphragm, superior vena cava and aorta—can be required to obtain macroscopic radical excision. These extended resections—very often requiring pneumonectomy and contiguous structures resection—represent the most challenging surgical interventions in oncology, being both demolition and reconstruction technically demanding and usually performed by a multidisciplinary team (thoracic surgeon, cardiac surgeon, general surgeon and orthopedic). However, postoperative morbidity and mortality remain high—almost doubled as compared with that of standard pneumonectomy and so an accurate balance should always be performed before offering such procedures as the best treatment option.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ferlay J, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2014;136:E359–86.

    Article  Google Scholar 

  2. Gridelli C, Rossi A, Carbone DP, Guarize J, Karachaliou N, Mok T, Petrella F, Spaggiari L. Rosell R non-small-cell lung cancer. Nat Rev Dis Primers. 2015;21(1):15009.

    Article  Google Scholar 

  3. Klepetko W. Surgical intervention for T4 lung cancer with infiltration of the thoracic aorta: are we back to the archetype of surgical thinking? J Thorac Cardiovasc Surg. 2005;129(4):727–9.

    Article  Google Scholar 

  4. Patterson GA. Extended pulmonary resection. In: Pearson FG, Cooper JD, et al. Thoracic surgery, vol. 1, 2nd ed. New York: Churchill-Livingstone; 2002, p. 1045–61.

    Google Scholar 

  5. Borri A, Leo F, Veronesi G, Solli P, Galetta D, Gasparri R, Petrella F, Scanagatta P, Radice D, Spaggiari L. Extended pneumonectomy for non-small cell lung cancer: morbidity, mortality, and long-term results. J Thorac Cardiovasc Surg. 2007;134(5):1266–72.

    Article  Google Scholar 

  6. Chansky K, Detterbeck FC, Nicholson AG, Rusch VW, Vallières E, Groome P, Kennedy C, Krasnik M, Peake M, Shemanski L, Bolejack V, Crowley JJ, Asamura H, Rami-Porta R. IASLC staging and prognostic factors committee, advisory boards, and participating institutions. The IASLC lung cancer staging project: external validation of the revision of the TNM stage groupings in the eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2017;12(7):1109–21.

    Article  Google Scholar 

  7. Leo F, Solli P, Veronesi G, Radice D, Floridi A, Gasparri R, et al. Does chemotherapy increase the risk of respiratory complications after pneumonectomy? J Thorac Cardiovasc Surg. 2006;132:519–23.

    Article  Google Scholar 

  8. Kawaguchi K, Yokoi K, Niwa H, Ohde Y, Mori S, Okumura S, Shiono S, Ito H, Yano M, Shigemitsu K, Hiramatsu Y, Okami J, Saito H. Trimodality therapy for lung cancer with chest wall invasion: initial results of a phase II study. Ann Thorac Surg. 2014;98(4):1184–91.

    Article  Google Scholar 

  9. Mansour KA, Thourani VH, Losken A, et al. Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg. 2002;73(6):1720–5 discussion 1725-6.

    Article  Google Scholar 

  10. McCormack PM. Use of prosthetic materials in chest-wall reconstruction. Surg Clin North Am. 1989;69:965–76.

    Article  CAS  Google Scholar 

  11. Wen X, Gao S, Feng J, Li S, Gao R, Zhang G. Chest-wall reconstruction with a customized titanium-alloy prosthesis fabricated by 3D printing and rapid prototyping. J Cardiothorac Surg. 2018;13(1):4.

    Article  Google Scholar 

  12. Marulli G, Dell’amore A, Calabrese F, Schiavon M, Daddi N, Dolci G, Stella F, Rea F. Safety and effectiveness of cadaveric allograft sternochondral replacement after sternectomy: a new tool for the reconstruction of anterior chest wall. Ann Thorac Surg. 2017;103(3):898–905.

    Article  Google Scholar 

  13. Petrella F, Radice D, Borri A, Galetta D, Gasparri R, Casiraghi M, Tessitore A, Pardolesi A, Solli P, Veronesi G, Rizzo S, Martella S, Rietjens M, Spaggiari L. Chest wall resection and reconstruction for locally recurrent breast cancer: from technical aspects to biological assessment. Surgeon. 2016;14(1):26–32.

    Article  Google Scholar 

  14. LeRoux BT, Shama DM. Resection of tumors of the chest wall. Curr Probl Surg. 1983;20:345–86.

    Article  CAS  Google Scholar 

  15. Graeber GM, Langenfeld J. Chest wall resection and reconstruction. In: Franco KL, Putman JR, editors. Advanced therapy in thoracic surgery. London: BC Decker; 1998. p. 175–85.

    Google Scholar 

  16. Weyant MJ, Bains MS, Venkatraman E, et al. Results of chest wall resection and reconstruction with and without rigid prosthesis. Ann Thorac Surg. 2006;81(1):279–85.

    Article  Google Scholar 

  17. Spaggiari L, Leo F, Veronesi G, Solli P, Galetta D, Tatani B, Petrella F, Radice D. Superior vena cava resection for lung and mediastinal malignancies: a single-center experience with 70 cases. Ann Thorac Surg. 2007;83(1):223–9.

    Article  Google Scholar 

  18. Spaggiari L, Galetta D, Veronesi G, Leo F, Gasparri R, Petrella F, Borri A, Pelosi G, Venturino M. Superior vena cava replacement for lung cancer using a heterologous (bovine) prosthesis: preliminary results. J Thorac Cardiovasc Surg. 2006;131(2):490–1.

    Article  Google Scholar 

  19. Spaggiari L, Petrella F, Leo F, Veronesi G, Solli P, Borri A, Galetta D, Gasparri R, Scanagatta P. Superior vena cava resection for lung and mediastinal malignancies. Multimed Man Cardiothorac Surg. 2006;2006(1009):mmcts.2005.001511.

    Google Scholar 

  20. Galetta D, Borri A, Casiraghi M, Gasparri R, Petrella F, Tessitore A, Serra M, Guarize J, Spaggiari L. Outcome and prognostic factors of resected non-small-cell lung cancer invading the diaphragm Interact. Cardiovasc Thorac Surg. 2014;19(4):632–6.

    Google Scholar 

  21. Yokoi K, Tsuchiya R, Mori T, Nagai K, Furukawa T, Fujimura S, et al. Results of surgical treatment of lung cancer involving the diaphragm. J Thorac Cardiovasc Surg. 2000;120:799–805.

    Article  CAS  Google Scholar 

  22. Marseu K, Minkovich L, Zubrinic M, Keshavjee S. Anesthetic considerations for pneumonectomy with left atrial resection on cardiopulmonary bypass in a patient with lung cancer: a case report. A A Case Rep. 2017;8(3):61–3.

    Article  Google Scholar 

  23. D’Aiuto M, Veronesi G, Pompilio G, Gasparri R, Presicci F, Galetta D, Biglioli P, Spaggiari L. Extended right pneumonectomy with partial left atrial resection for primary leiomyosarcoma of the mediastinum. J Thorac Cardiovasc Surg. 2005;129(3):694–5.

    Article  Google Scholar 

  24. Spaggiari L, D’Aiuto M, Veronesi G, Pelosi G, de Pas T, Catalano G, de Braud F. Extended pneumonectomy with partial resection of the left atrium, without cardiopulmonary bypass, for lung cancer. Ann Thorac Surg. 2005;79(1):234–40.

    Article  Google Scholar 

  25. Le Brigand H. Notions tactiques communes. In: Le Brigand H, editors. Nouveau traite de technique chirurgicale. Appareil respiratoire, mediastin, paroi thoracique. Paris: Masson; 1973. p. 165–239.

    Google Scholar 

  26. Klepetko W, Wisser W, Bîrsan T, Mares P, Taghavi S, Kupilik N, Wolner E. T4 lung tumors with infiltration of the thoracic aorta: is an operation reasonable? Ann Thorac Surg. 1999;67(2):340–4.

    Article  CAS  Google Scholar 

  27. Ohta M, Hirabayasi H, Shiono H, Minami M, Maeda H, Takano H, Miyoshi S, Matsuda H. Surgical resection for lung cancer with infiltration of the thoracic aorta. J Thorac Cardiovasc Surg. 2005;129(4):804–8.

    Article  Google Scholar 

  28. Marulli G, Rendina EA, Klepetko W, Perkmann R, Zampieri D, Maurizi G, Klikovits T, Zaraca F, Venuta F, Perissinotto E, Rea F. Surgery for T4 lung cancer invading the thoracic aorta: do we push the limits? J Surg Oncol. 2017;116(8):1141–9.

    Article  Google Scholar 

  29. Yokoi K, Taniguchi T, Usami N, Kawaguchi K, Fukui T, Ishiguro F. Surgical management of locally advanced lung cancer. Gen Thorac Cardiovasc Surg. 2014;62(9):522–30.

    Article  Google Scholar 

  30. Schirren J, Donges T, Melzer M, Schonmayr R, Eberlein M, Bolukbas S. En bloc resection of non-small-cell lung cancer invading the spine. Eur J Cardiothorac Surg. 2011;40:647–55.

    PubMed  Google Scholar 

  31. Grunenwald DH, Mazel C, Girard P, Veronesi G, Spaggiari L, Gossot D, et al. Radical en bloc resection for lung cancer invading the spine. J Thorac Cardiovasc Surg. 2002;123:271–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy

    Francesco Petrella & Lorenzo Spaggiari

  2. Department of Oncology and Hemato-Oncology, School of Medicine, University of Milan, Milan, Italy

    Francesco Petrella & Lorenzo Spaggiari

Authors
  1. Francesco Petrella
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lorenzo Spaggiari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Petrella .

Editor information

Editors and Affiliations

  1. “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania

    Claudiu E. Nistor

  2. Royal Papworth Hospital, Cambridge, UK

    Steven Tsui

  3. Koşuyolu Heart and Research Hospital, Istanbul, Turkey

    Kaan Kırali

  4. “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania

    Adrian Ciuche

  5. Royal Papworth Hospital, Cambridge, UK

    Giuseppe Aresu

  6. The University Hospital of Bern, Bern, Switzerland

    Gregor J. Kocher

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Petrella, F., Spaggiari, L. (2020). Pulmonary Resections in the Extensive Pulmonary Pathology. In: Nistor, C.E., Tsui, S., Kırali, K., Ciuche, A., Aresu, G., Kocher, G.J. (eds) Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-40679-0_34

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-40679-0_34

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-40678-3

  • Online ISBN: 978-3-030-40679-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation