For video-assisted thoracic surgery (VATS) on metastatic pulmonary tumors, wedge resection using an endo-stapler is the standard procedure in many institutions. However, this procedure can miss lesions or compromise surgical margins, particularly with small, deep lesions. The planned pulmonary resection in this study is a surgical method for pulmonary resection aimed at a previously assigned pulmonary area. We determine the pulmonary area for anatomical or nonanatomical resection before surgery on the basis of tumor location in relation to the anatomical distribution of pulmonary vessels.
Multidetector row computed tomography (MDCT) angiography contributed to preoperative planning for 12 patients with single (n = 11) or dual (n = 1) pulmonary metastases (diameter <3 cm) in the same lobe.
Planned surgical procedures were nonanatomical stapling resection (partial resection) (n = 6) or segmentectomy (n = 6). One patient required conversion to lobectomy from segmentectomy, but all patients underwent curative pulmonary resection.
Preoperative planning of VATS pulmonary resection using MDCT angiography allows reliable pulmonary resection for metastatic tumors.