Elia S
Università degli Studi di Napoli Federico II, Facoltà di Medicina e Chirurgia, Cattedra di Chirurgia Toracica.
Minerva Chir. 1997 Apr;52(4):397-401.
Authors report their experience concerning surgical treatment of thoracic recurrence from previously operated breast cancer. 96 patients were treated: 9 with loco-regional chest wall recurrence, 84 with malignant pleural effusion, 3 with solitary lung metastasis. Eight of 9 cases with chest wall recurrence underwent skin and soft tissue "en bloc" resection while in one case a thoracectomy was performed. Malignant pleural effusions were treated by thoracentesis in 21 cases (25%), tube thoracostomy in 8 (4.76%), tube thoracostomy plus chemical pleurodesis in 54 (64.2%) and pleurectomy in one case (1.19%). In all the cases with solitary lung metastasis a wedge resection was performed. Two out of 9 patients with chest wall recurrence are not evaluable as they did not enter the minimum follow-up period (15 months), 6 died after a mean period of 18.6 months (range 15-25) following surgery and one is alive at the end of the follow-up (39 months). Among the 3 patients with solitary lung metastasis 2 died respectively 26 and 31 months after procedure and 1 is alive at 28 months. Above 54 patients treated by tube thoracostomy plus pleurodesis for malignant pleural effusion, 35 showed a complete response, 13 a partial response and 6 were non-responders. No postoperative complications were observed in the patient who underwent pleurectomy while an almost complete resolution of the pain was achieved.
作者报告了他们在手术治疗既往接受过手术的乳腺癌胸段复发方面的经验。共治疗了96例患者：9例为胸壁局部复发，84例为恶性胸腔积液，3例为孤立性肺转移。9例胸壁复发患者中，8例行皮肤及软组织“整块”切除，1例行胸廓切除术。21例（25%）恶性胸腔积液患者采用胸腔穿刺治疗，8例（4.76%）行胸腔闭式引流，54例（64.2%）行胸腔闭式引流加化学性胸膜固定术，1例（1.19%）行胸膜切除术。所有孤立性肺转移患者均行楔形切除术。9例胸壁复发患者中有2例因未达到最短随访期（15个月）而无法评估，6例术后平均18.6个月（范围15 - 25个月）死亡，1例在随访结束时（39个月）存活。3例孤立性肺转移患者中，2例分别在术后26个月和31个月死亡，1例在28个月时存活。在54例接受胸腔闭式引流加胸膜固定术治疗恶性胸腔积液的患者中，35例完全缓解，13例部分缓解，6例无反应。接受胸膜切除术的患者未观察到术后并发症，且疼痛几乎完全缓解。
