Pulmonary Resections in the Extensive Pulmonary Pathology



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.


Lung cancer Extended resection Chest wall Superior vena cava Left atrium 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryEuropean Institute of OncologyMilanItaly
  2. 2.Department of Oncology and Hemato-Oncology, School of MedicineUniversity of MilanMilanItaly

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