Bilateral pulmonary metastectomy through a unilateral single-port thoracoscopic approach

A 58-year-old woman underwent radical proctectomy 19 months prior to admission. The initial diagnosis was rectal adenocarcinoma of pathological stage T2N0M0. She was discharged five days after the operation. She was followed by abdominal computed tomographic (CT) scan at 3, 9 and 18 months after the operation. Eighteen months after the operation, follow-up abdominal CT scan revealed tiny nodules in the bilateral lower lobes. Subsequent CT scan of the chest showed two tiny nodules in the right lower lobe and a single tiny nodule in left lower lobe. She then underwent single port thoracoscopic surgery through the right side for resection of the nodules. Using a single port wound, we excised the two tiny nodules on the right side and the one tiny nodule in the left lower lobe across the mediastinum. She was discharged four days later. The final pathology report showed those three nodules were metastases from an adenocarcinoma in the colon.