Combined pulmonary and thoracic wall resection for XXXX .

@entity1 @entity11379 @entity5 @entity957 @entity2 @entity2802
BACKGROUND: @entity2 with thoracic wall involvement constitutes @entity5 . The management of @entity1 with this condition is complicated. However, improvement in perioperative care coupled with advances in surgical technique have enabled a more aggressive approach to the problem to be adopted. METHODS: A retrospective review was carried out of 58 @entity1 (40 @entity1 ) of mean age 63 years who underwent thoracotomy for @entity2 with chest wall invasion between 1980 and 1993. RESULTS: Chest wall resection was performed in 55 @entity1 (94.8%); in three @entity1 the discovery of N2 disease at operation precluded resection. The @entity2802 status was T3N0M0 in 38 @entity1 , T3N1M0 in 13, and T3N2M0 in seven. @entity957 was the commonest cell type (26 @entity1 ). Reconstruction of the chest wall was performed in 29 @entity1 (Marlex mesh in six, Marlex- @entity11379 in 22, myocutaneous flap in one @entity1 ). The morbidity and mortality were 22.4% and 3.4% respectively. Follow up was complete in 51 @entity1 . Nineteen (37.2%) survived > or = 5 years. The absolute five year survival for N0 and N1 disease was 44.7% and 38.4%, respectively. No @entity1 with N2 disease survived five years. CONCLUSIONS: In @entity1 with @entity2 and chest wall invasion, combined pulmonary and thoracic wall resection offers the prospect of cure with minimal morbidity and mortality. The prognosis of @entity1 with coexistent N2 disease remains poor.
