Thoracoscopic resection of pulmonary metastasis: current practice and results.
Video-assisted thoracoscopic surgery (VATS) is currently a routinely performed procedure for the management of early non small cell lung cancer. The oncological results of VATS in terms of local recurrence and overall survival are equivalent or superior to those of conventional thoracotomy with lower morbidity and hospital stay. In the field of pulmonary metastasectomy, current guidelines support a thoracotomy approach in order to properly palpate the lung and detect nodules too small to be identified on standard radiological examinations (typically less than 5mm in diameter). However, the oncological and clinical significance of these millimetric nodules is not known. This has led some thoracic surgeons to rethink the approach of solitary pulmonary metastasectomy: because of improvements in thin slice helical CT-scans, some support a VATS approach for solitary pulmonary nodules without formal bimanual palpation and suggest this allows equivalent oncological results and decreased surgical morbidity.
Division of Thoracic Surgery Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Jean Yannis
JY
Perentes
Division of Thoracic Surgery Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Thorsten
T
Krueger
Division of Pneumonology Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Alban
A
Lovis
Division of Thoracic Surgery Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Hans-Beat
HB
Ris
Division of Thoracic Surgery Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: Michel.Gonzalez@chuv.ch.
Michel
M
Gonzalez
D006801:Humans; D008168:Lung / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D059146:Metastasectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome
Pulmonary metastasectomy; Video-assisted thoracoscopic surgery