videoassisted thoracic surgery major pulmonary resection requiring control of the main pulmonary artery the purpose of this study is to examine the feasibility and safety of thoracoscopic major pulmonary resection requiring the crossclamping of the main pulmonary artery pa in comparison to an open thoracotomy performed in patients with lung cancer a retrospective database of 27 consecutive lung cancer patients who underwent either videoassisted thoracic surgery vats n13 or open thoracotomy n14 for a major pulmonary resection using these procedures was analyzed regarding the demographic perioperative histopathologic and outcome variables the thoracoscopic procedures were successfully performed in 12 of 13 patients 923 two groups showed no differences in the demographic perioperative histopathologic and staging variables both groups presented with no mortality the vats group showed better results regarding the length of epidural anesthesia p00066 additional analgesic requirements p00009 and morbidity p00213 than the open thoracotomy group despite the short followup time the two groups were comparable regarding both the recurrence and survival rates the results indicate that vats is feasible and safe for selected lung cancer patients requiring the crossclamping of the main pa with acceptable perioperative results in comparison to an open thoracotomy