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Thorac Cardiovasc Surg 2017; 65(05): 382-386
DOI: 10.1055/s-0036-1597990
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Video-Assisted Laser Resection of Lung Metastases—Feasibility of a New Surgical Technique

Christian Meyer
1   Department of Surgery, University Hospital Marburg, Marburg, Germany
,
Detlef Bartsch
1   Department of Surgery, University Hospital Marburg, Marburg, Germany
,
Nikolas Mirow
2   Department of Cardiac Surgery, University Hospital Marburg, Marburg, Germany
,
Andreas Kirschbaum
1   Department of Surgery, University Hospital Marburg, Marburg, Germany
› Author Affiliations
Further Information

Publication History

14 October 2016

05 December 2016

Publication Date:
22 January 2017 (online)

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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
 

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