An availability of video-assisted thoracic surgery for the resection of pulmonary metastases.

We report the use of video-assisted thoracic surgery (VATS) as a treatment for pulmonary metastases. Eight patients with metastatic lung cancer were treated with VATS techniques. These patients included 5 males and 3 females whose ages ranged from 34 to 61 years (average: 47.4). Their primary diseases were seminoma (n = 3), renal cell carcinoma (n = 2), colon carcinoma (n = 1), mammary carcinoma (n = 1) and choriocarcinoma (n = 1). Computed tomography (CT) scans with current generation scanners were performed preoperatively and revealed one metastatic lesion in each of five cases and two lesions in each of the other three cases. In one case, one lesion was located in each of the lungs. Tumor size ranged from 5 to 30 mm in diameter, and all lesions were in the peripheral field of the lung. VATS was carried out with three surgical ports for three cases, two surgical ports for one case, and only one port for two cases. For all cases, an endo-stapler was utilized. In two cases, the preoperative point-marking technique for tumors was employed under the guidance of CT imaging. All patients were discharged from the hospital with no complications, and were followed up with no evidence of lung recurrence. Our criteria in selecting patients for the VATS removal of metastatic lung tumors are as follows: 1) tumors are less than 30 mm in diameter in the peripheral lung, 2) the number of tumors detected by CT scan, etc., is one or two. We conclude that VATS is a good candidate for the resection of lung metastases in the selected cases. Long term outcome remains to be solved in the future.