Objective: To assess the impact of past liver metastases on the survival duration of patients who are undergoing surgery for lung metastases.Methods: We conducted a review of literature published from 2007 to 2014. Th...Objective: To assess the impact of past liver metastases on the survival duration of patients who are undergoing surgery for lung metastases.Methods: We conducted a review of literature published from 2007 to 2014. The studies were identified by searching Pub Med,MEDLINE, and Embase and were supplemented by a manual search of the references listed by the retrieved studies. The following search terms were used: lung metastasectomy, pulmonary metastasectomy, lung metastases, and lung metastasis. We selected retrospective and prospective studies published from 2007 to 2014 on patients with lung metastases from colorectal cancer and were undergoing surgery with curative intent. We excluded reviews, studies that focused on surgical techniques, patients who were treated non-surgically, analyses of specific subgroups of patients, and those that did not report follow-up of the patients undergoing surgery.Results: We identified 28 papers that assessed survival after lung metastases, 21 of which were mostly retrospective studies that identified previous liver metastases to explore their impact on patient survival. In more than half of the papers analyzed(63.2%),patients with a history of resected liver metastases had a lower survival rate than those who did not have such a history, and the difference was statistically significant in eight of these studies. However, data were presented differently, and authors reported mean survival time, survival rates, or hazard ratios.Conclusions: A history of liver metastases seems to be a negative prognostic factor, but the individual data need to undergo a meta-analysis.展开更多
The hemiclamshell incision is a valid but infrequent surgical alternative for the resection of tumors from mediastinum. This point makes this approach impossible to be studied under a randomized controlled trial. The ...The hemiclamshell incision is a valid but infrequent surgical alternative for the resection of tumors from mediastinum. This point makes this approach impossible to be studied under a randomized controlled trial. The triple association of thoracotomy, sternotomy and cervicothomy makes the hemiclamshell approach a high intensity postoperative pain surgery. However, there is no published data on this topic, and the reviewed articles only mention the analgesic regimens as a secondary point. Indeed, no author defines the best epidural drugs mixture for the patients. Multimodal analgesic regimen based on regional anesthesia should be used. Based on the recent advances on spinal opioids, morphine could be a good choice as epidural coadjutant to local anesthetics for hemiclamshell incision.展开更多
文摘Objective: To assess the impact of past liver metastases on the survival duration of patients who are undergoing surgery for lung metastases.Methods: We conducted a review of literature published from 2007 to 2014. The studies were identified by searching Pub Med,MEDLINE, and Embase and were supplemented by a manual search of the references listed by the retrieved studies. The following search terms were used: lung metastasectomy, pulmonary metastasectomy, lung metastases, and lung metastasis. We selected retrospective and prospective studies published from 2007 to 2014 on patients with lung metastases from colorectal cancer and were undergoing surgery with curative intent. We excluded reviews, studies that focused on surgical techniques, patients who were treated non-surgically, analyses of specific subgroups of patients, and those that did not report follow-up of the patients undergoing surgery.Results: We identified 28 papers that assessed survival after lung metastases, 21 of which were mostly retrospective studies that identified previous liver metastases to explore their impact on patient survival. In more than half of the papers analyzed(63.2%),patients with a history of resected liver metastases had a lower survival rate than those who did not have such a history, and the difference was statistically significant in eight of these studies. However, data were presented differently, and authors reported mean survival time, survival rates, or hazard ratios.Conclusions: A history of liver metastases seems to be a negative prognostic factor, but the individual data need to undergo a meta-analysis.
文摘The hemiclamshell incision is a valid but infrequent surgical alternative for the resection of tumors from mediastinum. This point makes this approach impossible to be studied under a randomized controlled trial. The triple association of thoracotomy, sternotomy and cervicothomy makes the hemiclamshell approach a high intensity postoperative pain surgery. However, there is no published data on this topic, and the reviewed articles only mention the analgesic regimens as a secondary point. Indeed, no author defines the best epidural drugs mixture for the patients. Multimodal analgesic regimen based on regional anesthesia should be used. Based on the recent advances on spinal opioids, morphine could be a good choice as epidural coadjutant to local anesthetics for hemiclamshell incision.
