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Original Articles: General Thoracic

Invited commentary

Thoracic Surgery, Massachusetts General Hospital, Blake 1570, 55 Fruit St, Boston, MA 02114

(Email: wright.cameron@mgh.harvard.edu).

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This article by Parsons and colleagues [1] addresses an important clinical problem in thoracic surgery, which is the accuracy in detecting pulmonary metastases [1]. Although resection of pulmonary metastases has never been proven to improve survival in a randomized clinical trial, complete resection has been a consistent prognostic factor in many phase 2 trials, suggesting the efficacy of resection and the importance of detecting and removing all metastatic disease. Modern computed tomographic (CT) scanning has greatly improved our preoperative detection of suspected metastatic disease with a single breath hold and fine slice thickness (2.5 to 5 mm).

Resection of peripheral small pulmonary metastases would seem an ideal indication for a video-assisted thoracic surgical approach (VATS). Indeed many surgeons have used a VATS approach . . . [Full Text of this Article]