[An assessment of the resectability of lung cancer by exploratory video thoracoscopy]

We describe our experience using exploratory video-assisted thoracoscopy (EVT) to definitively evaluate resectability in patients with lung cancer who are candidates for surgical resection. In a single procedure we performed full visual and surgical exploration of the pleural cavity, lung, mediastinum, as well as of the pericardial cavity when required. The technique was used in 151 patients. Resection was judged non viable in 18 (11.9%) and performance of exploratory thoracotomy was deemed unnecessary. In 3 cases thoracotomy proved necessary for exploration. Nineteen patients were treated by video-assisted surgery; standard thoracotomy was used to resect 111. Morbidity and mortality were null in the group undergoing EVT in whom resection was judged viable. We conclude that EVT should be used in all patients with lung cancer who are being considered for surgery before a thoracotomy is performed. EVT can be performed as part of the same surgical act, as it supposes a savings in exploratory thoracotomies (amounting to 11.9% in our series).