CONTROVERSIAL DISCUSSION ABOUT RADICALITY IN RESECTION OF LUNG METASTASES - OPEN RESECTION

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.