Thoracoscopic neodymium: Yttrium aluminum garnet laser resection of a pulmonary metastasis

Background. Patients with a history of malignant disease and new pulmonary lesions often are considered for resection to establish a diagnosis and, with certain histologic subtypes, to improve survival. Standard operative therapy consists of thoracotomy and wedge resection of the lesion. Early and late postoperative morbidity is substantial and related primarily to the thoracotomy incision. Methods. Advances in endoscopic surgical techniques and laser technology allowed for successful thoracoscopic resection of an isolated pulmonary metastasis in a 59‐year‐old man with a history of a T3NOMO renal cell carcinoma. Results. The margins of the specimen were free of tumor. The postoperative course was uncomplicated, and the patient was discharged on the fourth postoperative day. The morbidity associated with a standard thoracotomy was avoided, and an adequate resection was obtained. Conclusion. Continued success with thoracoscopic resection may have a significant impact on the management of selected patients with a history of malignant disease and new pulmonary lesions. Cancer 1992; 70:1873–1875.