Pneumosurgery in the Management of Colorectal Carcinomas

Česká verzia

Authors: M. Sobotka; T. Horváth; L. Mitáš; H. Bartoňková ^*; M. Číhalová ^**; B. Garajová; I. Kocák ^***; I. Kocáková ^***; S. Špelda ^***; J. Vomela
Authors place of work: Chirurgická klinika Fakultní nemocnice Brno-Bohunice, Lékařská fakulta Masarykovy univerzity, přednosta: prof. MUDr. Z. Kala, CSc. ; Radiologické oddělení Masarykova onkologického ústavu, vedoucí: prim. MUDr. H. Bartoňková ^*; Ústav patologické anatomie Fakultní nemocnice Brno-Bohunice, Lékařská fakulta Masarykovy univerzity, přednosta: doc. MUDr. J. Feit, CSc. ^**; Klinika komplexní onkologické péče Masarykova onkologického ústavu, přednosta: prof. MUDr. R. Vyzula, CSc. ^***
Published in the journal: Rozhl. Chir., 2010, roč. 89, č. 5, s. 310-314.
Category: Monothematic special - Original

Summary

Objective:
Surgically solved lung involvement in patients after surgery of colorectal cancer.

Materials and methods:
Altogether 15 patients, 9 men (median age in the time of lung diagnosis 67 years) and 6 women (median age 59 years) underwent classical open pulmonary surgery during 2003–2008 years from the follow-up cohort of 836 persons after operation due to colorectal cancer in the time period of 1996–2008 years.

The indication for lung surgery:
solitary pulmonary lesion. Procedures distribution: pulmonary lobectomy 7, bilobectomy 2, segmentectomy 4, wedge resection 2.

The requirement of the European Society of Thoracic Surgeons (ESTS) guidelines of complete pulmonary resection has been met by 10 operations (66.7%) with lobe specific lymphadenectomy. Histopathology investigation: Formalin fixed, paraffin embedded samples were investigated after hematoxylin-and-eosin staining, supplemented in case of need by immunohistochemistry of CK7, CK20 and TTF1.

Results:
Eleven pulmonary metastases were found, in two cases with interlobar lymfatics involvement. Two metachronous primary adenocarcinomas of the lung (ADL) were diagnosed, one of them with metastases into hilar lymphatics. In remaining two patients pulmonary chondrohamartoma was discovered.

Conclusion:
Solitary pulmonary opacity in patient after colorectal surgery might not represent simple metastasis explicitly. Complete resection is needed.

Key words:
colorectal cancer – pulmonary metastases – lymphadenectomy – surgery

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