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Laser-assisted lung metastasectomy: a systematic review
Marco Mammana1, Matteo Baldi2, Luca Melan2
1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua University Hospital, Via Giustiniani, 2, 35128, Padova, Italy. marco.mammana@aopd.veneto.it.
Updates in Surgery
|June 22, 2023
Summary
Laser-assisted resection (LAR) for lung metastases is a viable surgical option. This review found LAR comparable to conventional methods in outcomes like R0 resection and survival rates.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Laser-assisted resection (LAR) presents potential benefits for pulmonary metastases surgery.
- Comprehensive reviews on LAR's technical aspects, indications, and outcomes are limited.
Purpose of the Study:
- To systematically review the literature on laser-assisted resection (LAR) for pulmonary metastases.
- To analyze outcomes including morbidity, R0 resection, pulmonary function, and survival.
- To compare LAR outcomes with conventional resection techniques.
Main Methods:
- Systematic literature search for original articles on LAR of pulmonary metastases.
- Inclusion of 12 selected studies from an initial search of 2629 articles.
- Collection and comparison of data on morbidity, R0 rate, pulmonary function, overall survival (OS), and relapse-free survival (RFS).
Main Results:
- Post-LAR R0 rates ranged from 72-100%, with morbidity from 0-27.5%.
- Postoperative forced expiratory volume in 1s decline was 3.4-11%. Median OS and RFS were 42-77.6 and 9-34.1 months, respectively.
- LAR patients often had more metastases and bilateral disease, yet outcomes were comparable to conventional techniques, with no significant differences in R0, morbidity, or OS.
Conclusions:
- Laser-assisted resection (LAR) is a valid alternative for lung metastasectomy.
- LAR demonstrates comparable efficacy to conventional methods despite patient selection differences.
- Challenges include adopting video-assisted thoracoscopic approaches and assessing resection margins.
