Exploratory thoracotomy and its influence on the survival of patients with lung cancer.

摘要: PURPOSE: To evaluate diagnostic procedures, reasons for exploratory thoracotomy (ET), causes of unresectability lung cancer, possibility reducing numbers ETs, and the influence ET on survival. PATIENTS AND METHODS: Between 1990 1999, 1808 patients with cancer were operated on. was performed in 165 (9.1%) these cases. In total, 131 evaluable analysis. The clinical stages were: three stage IA, 28 IB, one IIA, 35 IIB, 50 IIIA, 10 IIIB (all due to invasion mediastinum), four IV (three ipsilateral pulmonary solitary suprarenal metastasis). control group calculating survival difference consisted 130 consecutive non-operated comparable characteristics (age, sex, stage, performance status, histology comorbidity) who diagnosed during period 1996–1998. RESULTS: procedure before comprised bronchoscopy all patients, transthoracic needle biopsy 13, cervical mediastinoscopy nine, parasternal mediastinotomy two thoracoscopy two, without proving unresectability. A CT scan 118 indicating resectability 33%, doubtful 64% 3%. Clinical surgical staging equal 3% IIB 24% 100% 75% IV. 30-day operative mortality 4.6%. diagnosis preoperatively unverified tumor patient, necessity pneumonectomy case poor function 11 119 (due mediastinum 98 thoracic wall vertebral body one, pleural metastases 17 patients). could have been avoided 15 (11%) patients. median both 11.1 months. not statistically significant (p = 0.420). CONCLUSION: be partly through a more accurate preoperative procedure. It does appear possible avoid limited reserve precluding resection larger than that predicted, nor as consequence intraoperative complications. Despite mortality, did significantly rate present study.