J. Schirren et al., CONTROVERSIAL DISCUSSION ABOUT RADICALITY IN RESECTION OF LUNG METASTASES - OPEN RESECTION, Langenbecks Archiv fur Chirurgie, 1996, pp. 1198-1198
The main problem in the surgery of lung metastases is to treat an alre
ady generalized disease with local surgical procedures. A careful sele
ction of patients by an interdisciplinary concept is necessary. In les
s than 50% of cases a precise number and location of metastases can be
assessed by preoperative staging using CT scan. Intraoperative palpat
ion of the lung is the most sensitive method to localize metastases. T
he radicality of resection is of prognostic significance for all types
of lung metastases, whereas anything between one to seven resected me
tastases does not influence the prognosis. Therefore, for curative res
ection of lung metastases median sternotomy or transversal thoracotomy
in case of a simultaneously bilateral approach or lateral thoracotomy
in case of unilateral surgery, respectively, are indicated depending
on the localization of the metastases and the individual risk factors
of the patients.