The surgical resection of pulmonary metastases is a
method of treatment accepted as habitual in thoracic
surgery. However, it continues to be a source of
controversy if this resection must be realised by
thoracotomy or by modern video-assisted techniques.
With the aim of finding a response to this controversy in
our work milieu, a review was made of the surgical
interventions carried out in order to resect pulmonary
metastases. Between January 1997 and December 2001,
56 patients were found whose pulmonary metastases
had been resected by videothorascopy out of a total of
252 metastasectomies (22.2%). The primary tumours
were classified in 4 groups: sarcoma (n=11); colorectal
(n=25); renal (n=5); and others (n=15). Videothoroscopy
was carried out on the right hemithorax (n=28), left
hemithorax (n=22) or on both at once (n=6). Operational
mortality was nil and the only morbidity attributable to
the technique was a defect of re-expansion following the
removal of the thoracic drainage in one patient. Using
the Kaplan-Meier method, the probability of survival in
this series of patients was 60.4% after 5 years, with an
average survival time of 48 months. All of this data
supports the use of videothorascopy in our milieu on
patients with pulmonary metastases. However, in the
light of the results, it is important in using this technique
to place special emphasis on obtaining good margins of
resection, due to the real risk of local recurrence on
these margins in the medium term