Possibilities of video-assisted thoracic surgery in diagnoses and treatment of intrathoracic malignant neoplasms
The paper presents the experience with video-assisted thoracoscopic surgery performed in 142 patients treated in P.A. Herzen Moscow Research Oncological Institute. Video-assisted thoracoscopy was made in 54(38%) patients for diagnostic purposes and in 88 (62%) for therapeutic intent. It was shown to be of high informative value in diagnosing intrathoracic changes found in cancer patients during a follow-up. The metastatic pattern of changes in the lung, pleura and intrathoracic lymph nodes was confirmed in 30 (66,7%), out of 45 patients; the changes were benign in 15 (33,3%) patients. Thoracoscopic fluorescence diagnostic was shown to be highly effective in detecting pleural spread unvisible during standard examination. Photodynamic therapy performed in 15 patients with malignant pleural effusion could eliminate pleural cavity liquid accumulation and improve quality of life. There was no recurrence of pleural effusion during a 24 months follow-up period. Video-assisted thorascopic resection for lung metastases was performed in 28 patients and was effective as a routine intervention: 5-year survival was 32,1%. A method of video-assisted lung resection of bilateral metastases may be an alternative to sternotomy and bilateral thoracotomy.