Pulmonary metastasectomy by VATS or open thoractomy: a systematic review and meta-analysis of long term outcomes

Background VATS has become an increasingly popular technique for the cardiothoracic surgeon. Its use in the treatment of malignancy has been an issue of debate previously. Whilst its use has been documented for the treatment of primary lung cancers, its use in metastasectomy has been questioned due to inability to palpate the lung (with the possibility of missing lesions not diagnosed by low sensitivity pre-operative CT) and the association with pleural and port site seeding. There remain no randomized trials and other high level evidence regarding the oncological outcomes of VATS versus open thoracotomy for pulmonary metastases.