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Lung volume reduction surgery (LVRS) is a treatment option for patients with severe emphysema. A multicentre randomised trial (NETT) found, that LVRS reduced symptoms from emphysema, and in selected patients with heterogen-ous emphysema it improved survival. Since NETT was performed, other studies have demonstrated positive outcomes, both symptomatic and for survival in previously classified high-risk patients. Post-operative mortality after LVRS is now negligible, which is often credited to minimally invasive techniques, greater experience with the patient group and improved operative equipment.

This review is about the initial diagnostic workup and the surgical treatment of patients with lung cancer in Denmark. Due to the development of international and national clinical guidelines for diagnosis and treatment of lung cancer, survival has increased. Data from 2005-2016 in the National Danish Lung Cancer Registry show an increase in: 1) the number of women being diagnosed, 2) the part of surgical candidates being thoracoscopically treated, 3) the number of patients being referred to surgery and 4) the survival rate.

Introduction: Esophageal perforation can within hours result in seriously-ill patients with a high risk of complications. The array of treatment options is many and minimal invasive methods are emerging., Materials and Methods: Six patients with esophageal perforations, who were managed successfully by thoracoscopic debridement, irrigation and drainage. The causes of the lesions and the importance of early diagnosis are described. The different treatment schemes are outlined, and the specifics of this thoracoscopic approach are described. The importance of port placement is underlined and illustrated in Figure 1., Results: The six patients with a median age of 70.5 years (29-80) were successfully treated with videothoracoscopic debridement, irrigation with saline and drainage. Median time in surgery was 91.5 min. and the in-hospital time was 17.5 days. There were no complications except for one patient with continuous bacterial contamination of the pleural cavity, necessitating chest tube treatment for weeks after discharge. No patient was re-operated nor had a fatal course., Discussion: The potential applications of thoracoscopic surgery as a minimal invasive treatment for esophageal perforations are discussed, as well as the advantages of a combination of videothorascopic drainage and placement of a covered expandable stent. This combination must be evaluated in future studies.

Introduction: This article reports the introduction of VATS (video-assisted thoracic surgery) lobectomy in lung cancer patients in our department., Methods: From 22 October 1999 to 15 December 2000, ten patients with peripheral primary lung cancer with no signs of spreading underwent VATS lobectomy. In an additional four patients, the resection started as VATS, but had to be converted to an open procedure., Results: No 30 day mortality or late complications were seen. One patient who developed empyema underwent surgery and one had a stroke, but with total remission., Discussion: We have shown that it is possible to introduce VATS lobectomy with acceptable results. A literature overview demonstrates that thoracoscopic lobectomies offer similar survival data to that of conventional surgery.