eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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vol. 19
Original paper

Role of video-assisted thoracoscopic surgery in pulmonary metastasectomy

Hussein Elkhayat
Hesham M. Hamza
Mahmoud H. Elshoieby
Mohamed I. Omar
Ebrahim Aboeleuon Gaber

Cardiothoracic Surgery Department, Faculty of Medicine, Assiut University, Asyut, Egypt
Surgical Oncology Department, South Egypt Cancer Institute, Assiut University, Asyut, Egypt
Kardiochirurgia i Torakochirurgia Polska 2022; 19 (4): 181-188
Online publish date: 2022/12/16
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There are sparse prospective studies investigating the role of video-assisted thoracoscopic surgery (VATS) in management of pulmonary metastasis.

To prospectively investigate short-term surgical and pathological outcomes for PM patients operated on by VATS or open thoracotomy (OT) for management of lung secondaries.

Material and methods
Between October 2017 and December 2020, patients undergoing pulmonary metastasectomy were recruited. Patients were assigned to undergo resection with either thoracotomy (group 1) or VATS (group 2) after multidisciplinary team discussions based on the number, size and location of pulmonary metastasis and underlying lung function. All related short-term surgical and pathologic outcomes for both groups were collected for analysis.

Of 58 patients enrolled, 21 were in group 1 and 37 in group 2. Colorectal cancer primary represented 40% of the cases. Patients in the VATS group were more likely to have solitary lesions that are peripherally located and removed by wedge resection, as opposed to patients in the thoracotomy group, who had more anatomical lung resections. More new nodules were likely to be detected during surgery in thoracotomy than VATS cases (p = 0. 027). However, 8 (out of 15) of the newly detected lesions were not malignant. Operative time, blood loss and hospital stay were in favor of VATS procedures.

In a highly selected cohort of pulmonary metastasis patients with favorable criteria (peripherally located, small, solitary/oligo-metastasis and cN0), VATS may provide acceptable onco-pathologic outcomes as compared to the standard open thoracotomy.


lung metastasis, lung secondaries, pulmonary metastasectomy, thoracoscopic resection, video-assisted thoracoscopic surgery

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