Cytoreductive Surgery and Hyperthermic Intrathoracic Chemotherapy by Video-Assisted Surgery for Pleural Malignancies. Technical Aspects and Safety Profile from A Single Center

Background Pleural malignancies are challenging conditions in terms of possibility of cure. Recent growing interest towards Hyperthermic Intrathoracic Chemotherapy (HITHOC) after Cytoreductive Surgery (CRS) has been referred. Minimally invasive approach (VATS) may be suggest in this context but evidence is still lacking. Methods A preliminary experience in seven patients submitted to cytoreductive surgery and HITHOC is described, with a focus on technical aspects related to VATS approach, operating median time and postoperative complication. Results A triportal VATS approach has been employed in all cases. Median time of surgery including pleural perfusion was 200 minutes (range 165-370). Mean blood losswas 217 cc (range 100 and 600). Thirty days’ mortality was nihil. Conclusions VATS cytoreductive surgery and HITHOC is a safeprocedure and could be proposed in the setting of a multimodality strategy employing adjuvant radio-chemotherapy in referral centers