Dissemination of malignant tumors after video-assisted thoracic surgery: a report of twenty-one cases. The Video-Assisted Thoracic Surgery Study Group.

Video-assisted thoracic surgical techniques are widely used for biopsy and resection of thoracic tumors, but studies of long-term outcomes have not been reported. Dissemination of tumor by these techniques is a potential hazard. Therefore we surveyed the surgical members of the Video-Assisted Thoracic Surgery Study Group to determine whether tumor implants thought to be directly related to video-assisted techniques had occurred. Surgeons reported 21 cases. The sites of recurrence were the incision (n = 14), pulmonary staple line (n = 2), pleura (n = 2), both staple line and incision (n = 1), both pleura and incision (n = 1), and both pleura and staple line (n = 1). Review of these cases illustrates the pitfalls of present video-assisted techniques for malignant tumors of the thorax.