Video-assisted pulmonary metastectomy is equivalent to thoracotomy regarding resection status and survival

Markowiak, Till and Dakkak, Beshir and Loch, Elena and Grosser, Christian and Klinkhammer-Schalke, Monika and Hofmann, Hans-Stefan and Ried, Michael (2021) Video-assisted pulmonary metastectomy is equivalent to thoracotomy regarding resection status and survival. JOURNAL OF CARDIOTHORACIC SURGERY, 16 (1): 84. ISSN , 1749-8090

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Abstract

Background Surgical resection of pulmonary metastases leads to prolonged survival if strictly indicated. Usually, thoracotomy with manual palpation of the entire lung with lymph node dissection or sampling is performed. The aim of this study was to evaluate the role of video-assisted thoracoscopic surgery (VATS) in pulmonary metastectomy with curative intent. Methods In this study, all patients with suspected pulmonary metastasis (n = 483) who visited the Center for Thoracic Surgery in Regensburg, between January 2009 and December 2017 were analysed retrospectively. Results A total of 251 patients underwent metastectomy with curative intent. VATS was performed in 63 (25.1%) patients, 54 (85.7%) of whom had a solitary metastasis. Wedge resection was the most performed procedure in patients treated with VATS (82.5%, n = 52) and thoracotomy (72.3%, n = 136). Postoperative revisions were necessary in nine patients (4.8%), and one patient died of pulmonary embolism after thoracotomy (0.5%). Patients were discharged significantly faster after VATS than after thoracotomy (p < 0.001). Complete (R0) resection was achieved in 89% of patients. The median recurrence-free survival was 11 months (95% confidence interval 7.9-14.1). During follow-up, eight (12.7%) patients in the VATS group and 42 (22.3%) patients in the thoracotomy group experienced recurrence (p = 0.98). The median overall survival was 61 months (95% confidence interval 46.1-75.9), and there was no significant difference with regard to the surgical method used (p = 0.34). Conclusions VATS metastasectomy can be considered in patients with a solitary lung metastasis. An open surgical approach with palpation of the lung showed no advantage in terms of surgical outcome or survival.

Item Type: Article
Uncontrolled Keywords: ; Metastectomy; Video-assisted thoracoscopic surgery; Lung metastases; Pulmonary metastases; Prognosis
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Abteilung für Thoraxchirurgie
Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V.
Depositing User: Dr. Gernot Deinzer
Date Deposited: 09 Aug 2022 08:04
Last Modified: 09 Aug 2022 08:04
URI: https://pred.uni-regensburg.de/id/eprint/46175

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