Is there a need for a utility thoracotomy during VATS major lung resections?
Eduardo A. Tovar, MDa a Department of Cardiothoracic Surgery, St. Jude Medical Center, 100 E Valencia Mesa Dr, Suite 301, Fullerton, CA 92835, USA e-mail: etovarmd{at}aol.com’ + u + ‘@’ + d + ”//–> To the Editor I read with interest the article by Iwasaki and associates [1] regarding their video-assisted thoracic surgical lung resection and mediastinal lymphadenectomy. In the abstract and the Material and Methods section of their article they contend that their two-window method employs two 2- 3-cm incisions. In their comment, however, they admit that one of their incisions needs to be at least 3 cm to extract the specimen from the chest cavity. They also state that in their last 80 patients rib retraction was kept to a minimum. I could not help imagining what it would be like to try to remove a pulmonary lobe without rib retraction and through an incision slightly larger than the one needed for a chest tube insertion (Fig 1). I reviewed the literature to establish what the quoted si