The role of video-assisted thoracic surgery in pulmonary metastases.

The role of VATS in the management of patients with isolated pulmonary metastases is clear when performed for diagnostic purposes. In those patients with metastases that are too small for needle biopsy, when needle biopsy has been unsuccessful, or when more tissue is necessary for analysis, a VATS wedge resection can be performed with a high degree of success and minimal morbidity or inconvenience. The value of VATS for therapeutic resection of pulmonary metastases has not been demonstrated. Ideally, multicenter trials could address this issue along with the many unanswered questions concerning the fundamental concept of resection of pulmonary metastases.