HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Vincenzo Ambrogi Tommaso Claudio Mineo Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ambrogi, V. Articles by Mineo, T. C. Search for Related Content PubMed PubMed Citation Articles by Ambrogi, V. Articles by Mineo, T. C.

Ann Thorac Surg 2000;70:1847-1852
© 2000 The Society of Thoracic Surgeons

---

Original article: general thoracic

Transxiphoid video-assisted pulmonary metastasectomy: relevance of helical computed tomography occult lesions

^a Department of Thoracic Surgery, Tor Vergata University, Rome, Italy
^b Department of General Surgery, Calai Hospital, Gualdo Tadino, Italy

Address reprint requests to Dr Mineo, Cattedra di Chirurgia Toracica, Università Tor Vergata, P.le Umanesimo, 10, 00144 Rome, Italy
e-mail: mineo{at}med.uniroma2.it

Presented at the Thirty-sixth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 31–Feb 2, 2000.

Background. The new transxiphoid video-assisted approach allows manual palpation of both lungs, thus permitting better evaluation of helical computed tomography (CT) in detection of pulmonary metastases.

Methods. From December 1995 to May 1999, 22 patients underwent a transxiphoid video-assisted pulmonary metastasectomy. Manual palpation of both lungs was possible in 18 patients, whereas only 13 had radiologic evidence of unilateral disease. Primaries were colon-rectum (n = 8), kidney (n = 3), uterus (n = 2), larynx (n = 2), limb osteosarcoma (n = 2), and one each of breast, skin melanoma, prostate, fibrosarcoma, and ovary.

Results. No perioperative death occurred. Fifty-eight lesions, 49 metastatic, were resected, whereas only 46 had been predicted by helical CT scan. Twelve occult lesions were discovered, eight of which were malignant. Overall sensitivity for proved metastases was 83.7% (41 of 49) and 75.8% (22 of 29) for those less than or equal to 5 mm. Mean follow-up was 15.27 months. Only 2 patients had pulmonary relapse at 6 and 12 months.

Conclusions. Despite helical CT, occult metastases may still be identified in almost one-third of the patients. The transxiphoid approach allows routine bilateral palpation and safe resection, and overcomes this critical limitation of video-assisted metastasectomy.

This article has been cited by other articles:

				A. M. Parsons, E. K. Ennis, B. C. Yankaskas, L. A. Parker Jr, W. B. Hyslop, and F. C. Detterbeck Helical Computed Tomography Inaccuracy in the Detection of Pulmonary Metastases: Can It Be Improved? Ann. Thorac. Surg., December 1, 2007; 84(6): 1830 - 1836. [Abstract] [Full Text] [PDF]

				J. Pfannschmidt, H. Dienemann, and H. Hoffmann Surgical Resection of Pulmonary Metastases From Colorectal Cancer: A Systematic Review of Published Series Ann. Thorac. Surg., July 1, 2007; 84(1): 324 - 338. [Abstract] [Full Text] [PDF]

				T. C. Mineo, V. Ambrogi, D. Mineo, and E. Pompeo Transxiphoid Hand-Assisted Videothoracoscopic Surgery Ann. Thorac. Surg., June 1, 2007; 83(6): 1978 - 1984. [Abstract] [Full Text] [PDF]

				E. Pompeo and T. C. Mineo Awake pulmonary metastasectomy J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 960 - 966. [Abstract] [Full Text] [PDF]

				G. D. Rubin, J. K. Lyo, D. S. Paik, A. J. Sherbondy, L. C. Chow, A. N. Leung, R. Mindelzun, P. K. Schraedley-Desmond, S. E. Zinck, D. P. Naidich, et al. Pulmonary Nodules on Multi-Detector Row CT Scans: Performance Comparison of Radiologists and Computer-aided Detection Radiology, January 1, 2005; 234(1): 274 - 283. [Abstract] [Full Text] [PDF]

				A. M. Parsons, F. C. Detterbeck, and L. A. Parker Accuracy of Helical CT in the Detection of Pulmonary Metastases: Is Intraoperative Palpation Still Necessary? Ann. Thorac. Surg., December 1, 2004; 78(6): 1910 - 1918. [Abstract] [Full Text] [PDF]

				F. C. Detterbeck and T. M. Egan Thoracoscopy using a substernal handport for palpation Ann. Thorac. Surg., September 1, 2004; 78(3): 1031 - 1036. [Abstract] [Full Text] [PDF]

				Y. Doki, K. Ichiki, M. Tsuda, M. Toge, T. Misaki, K. Usuda, and S. Sugiyama Complete port-accessed lobectomy by the muscle-sparing method Ann. Thorac. Surg., June 1, 2004; 77(6): 2230 - 2231. [Abstract] [Full Text] [PDF]

				Y. Saito, H. Omiya, K. Kohno, T. Kobayashi, K. Itoi, M. Teramachi, M. Sasaki, H. Suzuki, H. Takao, and M. Nakade Pulmonary metastasectomy for 165 patients with colorectal carcinoma: A prognostic assessment J. Thorac. Cardiovasc. Surg., November 1, 2002; 124(5): 1007 - 1013. [Abstract] [Full Text] [PDF]

				S. Margaritora, V. Porziella, A. D'Andrilli, A. Cesario, D. Galetta, G. Macis, and P. Granone Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur. J. Cardiothorac. Surg., June 1, 2002; 21(6): 1111 - 1114. [Abstract] [Full Text] [PDF]

				S. Piltz, G. Meimarakis, M. W. Wichmann, R. Hatz, F. W. Schildberg, and H. Fuerst Long-term results after pulmonary resection of renal cell carcinoma metastases Ann. Thorac. Surg., April 1, 2002; 73(4): 1082 - 1087. [Abstract] [Full Text] [PDF]