Thoracoscopic technique for pulmonary lobectomy and pneumonectomy

Major pulmonary resections are undoubtedly the most difficult operations to perform thoracoscopically. from May '91 to March '97 1048 videothoracoscopic operations were performed at our department. The majority of patients were operated on for lung cancer (83%) and the others for benign diseases (14%) or metastases located too deeply in the parenchyma and nota amenable to wedge resection. Out of 211 patients candidate to videolobectomy 16% required converse due to oncological reasons (16%) or technical problems (70%), mainly diffuse adhesions (7 pts), thick fissures (20 pts. and bleeding (6 patients).Infiltration of the parietal pleura and unexpected N2disease were the most frequent oncological causes. Postoperative course was uneventful in 90% of cases. larger series and longer follow up are required to assess the validity of the procedure.