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Francesco Petrella
Francesco Leo
Giulia Veronesi
Piergiorgio Solli
Alessandro Borri
Domenico Galetta
Roberto Gasparri
Paolo Scanagatta
Lorenzo Spaggiari
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Right arrow Lung - cancer

J Thorac Cardiovasc Surg 2009;138:244-245
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

"Circular clamp" excision: A new technique for lung metastasectomy

Francesco Petrella, MDa,*, Francesco Leo, MD, PhDa, Nelson Alves Dos Santos, MDa, Giulia Veronesi, MDa, Piergiorgio Solli, MD, PhDa, Alessandro Borri, MDa, Domenico Galetta, MDa, Roberto Gasparri, MDa, Paolo Scanagatta, MDa, Lorenzo Spaggiari, MD, PhDa,b

a Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy
b University of Milan School of Medicine, Milan, Italy

Received for publication April 18, 2008; accepted for publication June 10, 2008.

* Address for reprints: Francesco Petrella, MD, Department of Thoracic Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. (Email: francesco.petrella@ieo.it).

The first 20% of the full text of this article appears below.


   Introduction
 
Lung metastasectomy is an accepted procedure in selected patients and demonstrates good survival, depending on the primary tumor histology, disease-free interval, and number and location of the metastases.1Go

The aim of metastasectomy is radical tumor resection, saving as much healthy lung tissue as possible: Wedge resection, segmentectomy, and nodule excision are the most common surgical techniques for this procedure.2Go

Pulmonary nodule excision, the most parenchyma-sparing procedure, is indicated for small and central nodules not suitable for wedge resections because of their central location and theoretically requiring an anatomic segmentectomy or lobectomy. Lung nodule excision is usually performed by exposing the nodule with a pair of lung forceps, trying to further improve nodule exposure by a tampon mounted on another forceps and pushing behind the nodule.

This procedure can be difficult because the nodule is slippery and deeply embedded within the parenchyma, and lung tissue incision results in profuse bleeding even at a high coagulation level using an electric scalpel or laser devices. . . . [Full Text of this Article]






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