Surgical Treatment of Pulmonary Lesions in a Single Lung

We performed surgery on 4 patients who had previously undergone left pneumonectomy and presented a second pulmonary lesion (3 lung cancers; 1 metastasis from colon cancer). Patients were aged between 52 and 79 years; 3 were men. Wedge resection was performed in 3 patients and segmentectomy in the other. Preoperative forced expiratory volumes in the first second were 1940 mL (72%), 576 mL (29%), 1390 mL (63%), and 2370 mL (63%). There was no perioperative mortality; 1 patient presented an air leak for 7 days. Two patients were alive and disease-free at 12 and 15 months, and 2 died from causes unrelated to the tumor at 52 and 183 months. There was no deterioration in the quality of life. In selected cases, patients with a second tumor in a single lung can be treated surgically with little or no mortality and with a prolonged survival.

ResumenHemos intervenido a 4 pacientes con neumonectomía izquierda previa y una segunda lesión pulmonar tumoral (3 carcinomas de pulmón y una metástasis de carcinoma de colon). Las edades estaban comprendidas entre 52 y 79 años, y 3 de ellos eran varones. Se realizó resección en cuña en 3 casos y segmentectomía en el restante. El volumen espiratorio forzado en el primer segundo antes de la intervención quirúrgica era de 1.940 ml (72%), 576 ml (29%), 1.390 (63%) ml y 2.370 ml (63%), respectivamente. No hubo mortalidad perioperatoria; una paciente presentó fuga aérea durante 7 días. Dos pacientes estaban vivos y sin enfermedad a los 12 y 15 meses, y 2 fallecieron por causas no tumorales a los 52 y 183 meses. No hubo disminución de la calidad de vida. En casos seleccionados se puede intervenir a pacientes con un segundo tumor en un pulmón único, con escasa o nula mortalidad, y obtener supervivencias prolongadas.