Abstract
Background Our pilot study describes our initial experience to do a laser resection of lung
metastases under video-assisted thoracoscopic control via a minithoracotomy. With
this approach, if needed, mediastinal lymphadenectomy is also possible.
Methods In this study, 15 patients (11 men and 4 women, mean age: 60 years) with resectable
lung metastases of different solid primary tumors (colorectal cancer in seven patients,
melanoma in three patients, renal cell carcinoma in two patients, and one each with
oropharyngeal cancer, breast cancer, and seminoma) were included. An anterior minithoracotomy
incision (approximately 5–7 cm length) was created in the fifth intercostal space
and a soft tissue retractor (Alexis Protector; Applied Medical) was positioned. Two
additional working ports were inserted. The entire lung was palpated via the minithoracotomy.
All detected lung metastases were removed under thoracoscopic control. Nonanatomic
resections were performed using a diode-pumped neodymium-doped yttrium aluminium garnet
laser (LIMAX120; KLS Martin GmbH & Co KG) with a laser power of 80 W in a noncontact
modus. Deeper parenchymal lesions were sutured.
Results A total of 29 lung metastases up to 30 mm in size were resected and all metastases
diagnosed on preoperative imaging were detected. All diagnosed lung metastases were
completely resected (R0). The median operation time was 102 (range: 85–120) minutes.
Median blood loss was 47.6 mL and no postoperative complications occurred. Neither
local recurrences nor new lung metastases were observed within 6 months after the
procedures.
Conclusion Video-assisted laser resection of lung metastases is safe, effective, and fulfills
the requirements of modern lung metastases surgery.
Keywords
minimally invasive surgery - metastases - thoracoscopy/VATS - laser surgery
