手术切除是肺转移瘤治疗的选择之一,大量回顾性研究提示对原发灶已控制的患者,彻底切除肺转移瘤能带来生存获益。应用肺转移瘤切除术,需对患者进行综合评估。任何原发瘤病理类型,彻底切除都是主要的预后因素。无瘤间歇期长、肺转移瘤数量较少是有利的预后因素。推荐采用经胸肋三角手辅助胸腔镜双肺转移瘤切除的手术方式。肺门与纵隔淋巴结转移是手术的相对禁忌证。现有的影像学检查存在遗漏肺转移瘤的风险。肺转移瘤扩大切除术可使部分患者受益。部分肺转移瘤再发再切仍有生存获益,故肺转移瘤切除术需注意保护正常肺实质。我们就这些临床问题进行文献综述,以期为肺转移瘤的外科治疗提供参考。 Surgery is one of the options for the treatment of lung metastases, a large number of retrospective studies suggest that patients with primary tumors have been controlled, complete removal of lung metastases can bring survival benefit. Application of lung metastases resection, the need for a comprehensive assessment of patients. Any primary tumor pathological type, complete excision is the main prognostic factor. Long tumor-free intervals and fewer lung metastases are favorable prognostic factors. Recommended by the thoracic triangular hands assisted thoracoscopic lung metastases resection of the surgical approach. Hilar and mediastinal lymph node metastasis is the relative contraindication for surgery. Existing imaging studies have the risk of missing lung metastases. Enlarged resection of lung metastases can benefit some patients. Part of lung metastases recurrence and re-cutting still have survival benefit, so the resection of lung metastases need to pay attention to protect the normal lung parenchyma. We review the literature on these clinical issues in order to provide a reference for the surgical treatment of lung metastases.