Surgical Treatment For Metastatic Tumors Of Lung

Objective: To study the diagnosis,operative indicatio,preoperative evaluaion,operative method and the prognosis ofpulmonary metastasis.Method: To retrospectively analyze the clinical data of 12resections for pulmonary metastasis from 1996.1 to 2005.1.Results: There are 7 cases that the number of metastatictumors are same as the number of focus of infection showed by CTin preoperation when explorations were performed. There are 5cases that the number of metastatic tumors are more thanpreoperation, 3 cases that are showed 1 in preoperation but 2 inexplorations,2 cases that are showed 2 in preoperation but 3 inexplorations;they are all located in the same lung lobe.They are allpulmonary metastasis confirmed by pathology.There are 2 caseswith the diversion of lymphoid nodes,1 with the diversion oflymphoid nodes of the hilum of lung,the live time is 16 months;1with the diversion of lymphoid nodes of the eminence and thehilum of lung,the live time is 10 months.There are no seriouscomplications and no death surrounded operation. Follow-upvisiting after operation , the survival time of 10 cases are 1 year,the survival time of 5 cases are 3 years and the survival time of 3cases are 5 years.Conlusion: 1.Surgical treatment can extend the live time ofthe patients of pulmonary metastasis.2.Mostly patients ofpulmonary metastasis have no symptoms in the earlier andintermediate stage,for the patients have the primary malignantneoplastic history,the detections of chest X are necessary in therecheck and follow-up visit after operation,chest CT can bedetected if necessary.With the history, pulmonary metastasisshould be suspected,if focus of infections appear in the lung,thepatients with operative indications should be operative explored asearly as we can.3.The operative indications of the pulmonarymetastasis: (1) The primary malignant tumor has be controlled orhas be radical cured.(2) The pulmonary metastasis tumor must beconfined to one lung lobe and there are no other diversions.(3) Allthe metastasis tumors can be resected completely.(4) There are noother treatments better than surgical treatment.(5) Thecardiorespiratory function of patient can be tolerant to theoperation.4. Operative method: the trouble lung must be exploredcarefully,the numbers of metastases are often more than shown byCT when explored;in the procedur of operation,the principle oftow most must be followed,healthy lung tissue should be remainedmost , the tumors are resected most. Wedge resection is performedas far as possible,the resection of lung lobe or all lung can beconsidered if wedge resection can be performed. We should sweepthe lymphoid nodes in routine.