Merlier M, Leguerrier A, Bouquet P, N'Guimbous J F
J Chir (Paris). 1977;113(5-6):471-8.
19 patients with bilateral simultaneous pulmonary metastases were operated on between 1954 and april 1976 at the Marie-Lannelongue surgical centre. Sarcomas were twice as common as carcinomas. In 10 cases the thoracotomy was only unilateral, either because thoracotomy was not attempted on the other side owing to the diffuse nature of the lesions (8 cases) or because prior chemotherapy had permitted complete reduction of the metastases on the opposite side (2 cases). This thoracotomy remained exploratory in 47 p. cent of cases, radical removal of all the tumour nodules was possible in 53 p. cent of cases (10 patients). Peripheral resections of the lesions were the rule. But in 4 cases, lobectomy was carried out on one side. 7 of the 9 bilateral operations were performed during the same stage. There were no operative deaths. The late results are encouraging considering the number of sarcomas in which the prognosis is usually poor. Bilateral lesions are thus not an absolute contra-indication, provided one remains within reasonable anatomical and functional limits, in the fields of well-conducted anti-cancer strategy.
1954年至1976年4月期间，19例双侧同时性肺转移患者在玛丽 - 拉讷隆格外科中心接受了手术。肉瘤的发生率是癌的两倍。在10例病例中，开胸手术仅为单侧，其中8例是因为病变弥漫而未尝试对另一侧进行开胸手术，2例是因为术前化疗使对侧转移灶完全缩小。在47%的病例中，此次开胸手术仍为探查性手术，53%的病例（10例患者）能够彻底切除所有肿瘤结节。对病变进行外周切除是常规做法。但有4例患者一侧进行了肺叶切除术。9例双侧手术中有7例在同一阶段进行。无手术死亡病例。考虑到肉瘤的数量通常预后较差，其远期结果令人鼓舞。因此，在合理的解剖和功能范围内，只要在良好实施的抗癌策略领域内，双侧病变并非绝对禁忌证。
