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The journal «ONCOSURGERY» 2012, Vol.4, No 3

Multidisciplinary approach – further advance in thoracic oncology

Parshin VD, Belov YuV, Komarov RN, Babaev МА, Mirzoyan ОS, Podolyak DG, Nikoda VV

BV Petrovsky Russian Research Center of Surgery, Moscow, Russia
Contact: Mirzoyan OS, e-mail:

The multidisciplinary approach for treatment of patients with thoracic pathology allows to review rules of local respectability and functional operability. Nowadays, the further advancement of thoracic surgical oncology is directed on extension of surgical abilities in patients with locally advanced tumors and low functional reserves of cardiorespiratory system, concurrent diseases of vital organs.

Combined surgery was performed for locally advanced cancer in 429 patients. They were divide into 3 types: vasculo-atrial, trachebronchial and parietal-phrenic. Patients with severe cardiovascular co-morbidities underwent combined interventions directed on myocardial revascularization, maintenance of vital organ perfusion, recanalization of great vessels. The surgery should be started from revascularization of myocardium and the removal of tumor should be the second step. We have experience of such operations both under cardiopulmonary bypass and «off pump» surgery. The latter was performed for limited lung resections in patients with small tumors and extended surgery was preferably done under cardiopulmonary bypass.

Thus, the treatment of thoracic cancer patients with locally advanced tumors and severe co-morbidity becomes prerogative of multidisciplinary specialized medical institutions, having experience of current versatil surgery.

KEY WORDS: lung cancer, simultaneous surgery, combined surgery, extended pneumonectomy, prosthesis of aorta, resection of atrium.

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