title: Video-Assisted Laser Resection of Lung Metastases-Feasibility of a New Surgical Technique.
abstract: BackgroundOur pilot study describes our initial experience to do a laser resection of lung metastases under video-assisted thoracoscopic control via a minithoracotomy. With this approach, if needed, mediastinal lymphadenectomy is also possible.MethodsIn this study, 15 patients (11 men and 4 women, mean age: 60 years) with resectable lung metastases of different solid primary tumors (colorectal cancer in seven patients, melanoma in three patients, renal cell carcinoma in two patients, and one each with oropharyngeal cancer, breast cancer, and seminoma) were included. An anterior minithoracotomy incision (approximately 5-7 cm length) was created in the fifth intercostal space and a soft tissue retractor (Alexis Protector; Applied Medical) was positioned. Two additional working ports were inserted. The entire lung was palpated via the minithoracotomy. All detected lung metastases were removed under thoracoscopic control. Nonanatomic resections were performed using a diode-pumped neodymium-doped yttrium aluminium garnet laser (LIMAX120; KLS Martin GmbH & Co KG) with a laser power of 80 W in a noncontact modus. Deeper parenchymal lesions were sutured.ResultsA total of 29 lung metastases up to 30 mm in size were resected and all metastases diagnosed on preoperative imaging were detected. All diagnosed lung metastases were completely resected (R0). The median operation time was 102 (range: 85-120) minutes. Median blood loss was 47.6 mL and no postoperative complications occurred. Neither local recurrences nor new lung metastases were observed within 6 months after the procedures.ConclusionVideo-assisted laser resection of lung metastases is safe, effective, and fulfills the requirements of modern lung metastases surgery.
authors.affiliation: Department of Surgery, University Hospital Marburg, Marburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Surgery, University Hospital Marburg, Marburg, Germany.
authors.forename: Detlef
authors.initials: D
authors.lastname: Bartsch
authors.affiliation: Department of Cardiac Surgery, University Hospital Marburg, Marburg, Germany.
authors.forename: Nikolas
authors.initials: N
authors.lastname: Mirow
authors.affiliation: Department of Surgery, University Hospital Marburg, Marburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011013:Pneumonectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000295:instrumentation; D013908:Thoracotomy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult