ANATOMICAL RESECTIONS IN PULMONARY METASTASES : A 30-YEAR SINGLE-INSTITUTION EXPERIENCE

Le résumé fourni par la source

Background: Pulmonary metastasectomy is a key component of multimodal cancer treatment. While wedge resections are standard, anatomical resections may be necessary in specific cases. This study analyzed indications, procedural characteristics, and outcomes of anatomical resections. Methods: A 30-year retrospective study was conducted at the Thoracic Surgery Department, Abderrahmen Mami Hospital, Ariana, including patients who underwent pulmonary metastasectomy, excluding primary lung malignancies. Results: Among 341 patients, 61 (17.9%) required anatomical resections. The median age was 52 years, with a slight male predominance (52%). Right-sided lesions were most common (58%), mainly in the lower lobe. Central location and multiple metastases were the primary indications. Procedures included lobectomy (74%), segmentectomy (14.6%), bilobectomy (4.9%), and pneumonectomy (6.5%). Primary tumors originated from the gastrointestinal tract (n=13), breast (n=11), urological tract (n=9), and reproductive system (n=5). Postoperative morbidity was 9.8% (n=6), including infections (n=3), recurrent laryngeal nerve palsy (n=1), and myocardial infarction (n=1). One perioperative death was recorded. Non-anatomical resections had a lower complication rate (5%). Conclusion: Although wedge resection remains standard, anatomical resections are essential in select cases, particularly for central or multiple lesions. Despite slightly higher morbidity, they offer an acceptable safety profile in well-selected patients.

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