Video assisted thoracoscopic diagnosis and treatment of small pulmonary nodules: A report of 29 cases
- VernacularTitle:胸腔镜诊治肺部微小结节29例报告
- Author:
Yingtai CHEN
;
Xiaogang LI
;
Jun LIU
- Publication Type:Journal Article
- Keywords:
Lung;
Pulmonary tumor;
Small nodule;
VATS
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the feasibility of video assisted thoracoscopic surgery (VATS) in the diagnosis and treatment of small pulmonary nodules. Methods A total of 29 patients with small pulmonary nodules was diagnosed and treated by VATS from May 2000 to June 2005. During the operation, the lesion was detected by forefinger palpation to determine the location, size, feature, and relation to the pleura. In case of difficult location, the incision was extended to 4 cm in length, and the lesion was examined and palpated with operator’s two fingers. Pulmonary wedge resection was performed. Whether or not an open pulmonary lobectomy and mediastinal lymph node resection was required was determined according to pathological findings of intraoperative frozen-section biopsy. Results All the operations were successfully accomplished and no complications or deaths occurred peri-operatively. The location of nodule was determined with single forefinger palpation and no extended incision was needed. There were 11 patients with malignant nodules (11/29, 37.9%) and 18 benign nodules (18/29, 62.1%). A malignant nodule was confirmed eventually in 8 patients (57.1%) with suspected diagnosis of malignancy and in 3 patients with suspected diagnosis of benign lesions. Among 11 patients with “malignant” imaging signs, only 6 patients (54.5%) were at last confirmed to be malignant. Out of 21 patients with solitary pulmonary nodules, 7 were malignant; out of 8 patients with multiple pulmonary nodules, 4 were confirmed to be malignant. Eighteen patients with benign nodules were treated with wedge resection under VATS. In the remaining 11 patients with malignant nodules, a radical resection of the tumor and a mediastinal lymph node resection was conducted in 6 patients and a palliative wedge resection was performed in 5 patients. Conclusions Small pulmonary nodules are difficult to get a confirmative diagnosis. VATS can be used for the diagnosis and treatment of small pulmonary nodules and obtain a satisfactory prognosis.
