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Cardiothoracic Surgery |

Indications and Results of One-Stage Bilateral Thoracotomy Approach

Alexandru-Mihail Botianu*, MD; Petre Vlah-Horea Botianu, MD
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University of Medicine and Pharmacy, Tirgu-Mures, Romania


Chest. 2012;142(4_MeetingAbstracts):70A. doi:10.1378/chest.1389992
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Abstract

SESSION TYPE: Thoracic Surgery Posters II

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: The purpose of this paper is to evaluate the indications and results of one-stage bilateral thoracotomy approach in an unit with no lung transplantation programme.

METHODS: Between 01.01.1985-01.01.2012 our team has performed one-stage bilateral thoracotomies in a total number of 20 patients. Indications for this approach included: hydatid disease (one including a right thoracophrenotomy to approach a hepatic hydatid cyst) - 9 pts., thoracic trauma - 2 pts., bilateral metastases - 2 pts., bilateral empyema - 2 pts., bilateral blebs - 2 pts., primary lung cancer + contralateral metastase - 1 pt., bilateral hidro-pneumothorax - pleural carcinomatosis and trapped lung - 1 pt., bilateral metallic foreign bodies (suicide attempt) - 1 pt. In other 4 cases where this approach was planned, the second procedure was postponed at the request of our anesthesia colleagues (patients not included in this study). All the procedures were performed by the same team.

RESULTS: We encountered no mortality. None of the patients required prolonged postoperative mechanical ventilation. One patient with bilateral empyema developed a residual cavity that eventually required a thoracomyoplasty procedure. Intensive care unit stay ranged between 1 and 5 days, with a median of 2 days. Overall postoperative hospitalization ranged between 12 and 67 days, with a median of 19 days.

CONCLUSIONS: For patients with bilateral thoracic diseases one stage bilateral thoracotomy is a good option. Carefull selection of the patients allows a low mortality and morbidity.

CLINICAL IMPLICATIONS: One-stage bilateral thoracotomy may be performed for a wide range of diseases, not only for lung transplantation and lung volume reduction surgery. The major advantages are functional one, psychologic and echonomical - reduction of costs to almost one half.

DISCLOSURE: The following authors have nothing to disclose: Alexandru-Mihail Botianu, Petre Vlah-Horea Botianu

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University of Medicine and Pharmacy, Tirgu-Mures, Romania

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thoracotomy

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