Current Thoracic Surgery

Background: Re-do surgery may be necessary for recurrent primary lung carcinoma or a different indication. However, some difficulties such as adhesions may be encountered during re-do surgeries. We hypothesized that people with hypertrophic incision scars have severe adhesions during intuitive surgery. Therefore, this study aimed to share our experience with postoperative incision scars and the amount of pleural adhesions.

Materials and Methods: Patients who underwent reoperation (with thoracoscopy and / or thoracotomy) and who had a previous operation on the same side were retrospectively evaluated. The indications of the first and second operations, degree of adhesions, need to perform thoracotomy, and keloid and scar formations of the first incision were analyzed.

Results: A total of 22 patients (mean age, 60.1 ± 9.8; range, 19-83 years) who underwent reoperation on the same side were evaluated; 18 of them underwent reoperation due to the recurrence of the first tumor. Hypertrophic scars were observed at the incision site in six (one of them was with keloid formation), advanced pleural adhesions were found in five, and thoracotomy was required in three patients due to severe adhesions. Severe pleural adhesions were observed in 7 of 16 patients without hypertrophic scar.

Conclusions: Postoperative adhesion is a major cause of difficulties and complications during repeat surgeries. More severe pleural adhesions were observed in patients who had hypertrophic scar formation in the previous incision scar, and this observation influenced the clinical approaches.