Techniques for Pulmonary Metastasectomy

Surgery for pulmonary metastases need to be developed individually and in an interdisciplinary approach. The aim of surgery is not only to remove metastases but also to increase the patient’s chance of survival. Two main principles direct the surgical approach for resection of pulmonary metastases: complete resection of malignancy and maximal sparing of normal lung tissue. For nodules located peripherally, stapled wedge resection is generally the preferred treatment but for large or central lesions, segmental resections, lobectomy, or occasionally, pneumonectomy may be required. Other techniques have been proposed as an alternative, both to save as much surrounding lung as possible and reduce trauma to patients with a low cardiopulmonary reserve. In this chapter we will discuss the techniques for pulmonary metastases.