Ann Thorac Surg 2003;76:342
© 2003 The Society of Thoracic Surgeons
Correspondence
Remarks about usefulness of videothoracoscopic intrapericardial examination of pulmonary vessels to assess the resectability of clinical T4 lung cancer
Alain J. Wurtz, MDa
a Clinique de Chirurgie Thoracique CHRU, Hôpital Calmette, Bd du Pr. J. Leclercq, 59037 Lille Cedex, France
e-mail: awurtz{at}chru-lille.fr
To the Editor:
I read with great interest the article by Loscertales and co-workers [1] about videothoracoscopic intrapericardial examination of pulmonary vessels to identify resectable clinical T4 lung cancer. The authors recommend the use of this technique to assess the potential resectability of clinical T4 lung cancer. My colleagues and I [2–4] have been working on pericardioscopy through a subxiphoid approach since 1985 and have focused mainly on neoplastic direct or indirect pericardial invasion. In 1992, we [2] reported our experience with the assessment of T4 lung cancer resectability through this particular approach before thoracotomy. Results were very encouraging. Since then, the accuracy of thoracic computed tomographic scanning, transesophageal ultrasound, and cine magnetic resonance imaging to evaluate potential great-vessel invasion has improved dramatically. Consequently, videothoracoscopy does not contribute additional information. In the few instances when resectability cannot be determined, only a cautious open-field sharp dissection can provide the answer.
References
- Loscertales J., Jiménez-Merchán R., Congregado-Loscertales M., et al. Usefulness of videothoracoscopic intrapericardial examination of pulmonary vessels to identify resectable clinical T4 lung cancer. Ann Thorac Surg 2002;73:1563-1566.[Abstract/Free Full Text]
- Wurtz A., Chambon J.P., Millaire A., Saudemont A., Ducloux G. La péricardoscopie: techniques, indications et résultats. A propos d’une expérience de 70 cas [Pericardioscopy: techniques, indications and results. Apropos of an experience with 70 cases]. Ann Chir 1992;46:188-193.[Medline]
- Nugue O., Millaire A., Porte H., et al. Pericardioscopy in the etiologic diagnosis of pericardial effusion in 141 consecutive patients. Circulation 1996;94:1635-1641.[Abstract/Free Full Text]
- Porte H.L., Janecki-Delebecq T.J., Finzi L., Métois D.G., Millaire A., Wurtz A.J. Pericardioscopy for primary management of pericardial effusion in cancer patients. Eur J Cardio-thorac Surg 1999;16:287-291.[Abstract/Free Full Text]
