Midterm results of thoracoscopic surgery for pulmonary metastases especially from colorectal cancers

Masazumi Watanabe, Hiroyuki Deguchi, Mitsuharu Sato, Yuichi Ozeki, Susumu Tanaka, Yotaro Izumi, Koichi Kobayashi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Indications for thoracoscopic metastatectomy remain controversial because not all metastatic tumors may be detected without the manual palpation that is possible with thoracotomy. However, the accuracy (92%) of preoperative lung imaging in patients with one or two lesions led us to re- evaluate thoracoscopic metastatectomy with patient survival as the primary end point. Thoracoscopic wedge resection using an endoscopic stapling device or video-assisted thoracic surgery (VATS) lobectomy was performed in patients with one or two pulmonary metastases. Thoracoscopic resection was performed in 27 patients with 22 solitary lesions and 5 patients with two lesions. The primary tumors were colorectal cancer (15), testicular cancer (3), osteosarcoma (2), and seven other histologies. In 5 of 27 patients (18.5%) a thoracoscopic operation was converted to a VATS procedure, which requires minithoracotomy to identify metastasis primary by digital palpation. The 3- year survival rate for colorectal cancer patients who underwent thoracoscopic resection was 56.4%, in comparison to 48.6% in historical control thoracotomy patients (n = 16). There was no statistically significant difference between the two groups. Thoracoscopic resection of one or two colorectal cancer lung metastases results in a survival rate similar to standard thoracotomy, and thereby provides an acceptable alternative to this more invasive approach.

Original languageEnglish
Pages (from-to)195-200
Number of pages6
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques - Part A
Volume8
Issue number4
DOIs
Publication statusPublished - 1998 Aug

ASJC Scopus subject areas

  • Surgery

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