Use of transesophageal echocardiography for evaluation of resectability of lung cancer.
BACKGROUND
When patients with lung cancer are to undergo surgical resection, chest x-ray and computed tomography (CT) are widely used for evaluation of staging and of the resectability of the lesion. Unfortunately, the above methods cannot always provide sufficient information about resectability and some patients undergo unnecessary operations. Transesophageal echocardiography (TEE) has opened a new window for viewing cardiac structure and function. By TEE, one can also image the surrounding tissues and great vessels under continuous monitoring.


METHODS
We pre-operatively applied the awake TEE method in twenty whose chest CT showed suspected invasion of the heart by the tumor.


RESULTS
Our experience showed the following: (1) TEE can clearly identify whether lung cancer has invaded the heart and/or great vessels and therefore avoiding unnecessary operation; (2) Two patients had tumor seen abutting epicardium and/or aorta without invasion (under continuous imaging). Two patients had tumor compressing the right and left atrium with intact but not invading pericardium, and underwent successful surgical resection.


CONCLUSIONS
We concluded that it is useful to apply TEE preoperatively in evaluating the resectability of the lung cancer especially when a chest CT shows suspicion of local invasion of the heart and great vessels; thus unnecessary thoracotomy can be avoided.
Wang
K Y
KY
Department of Anesthesiology, Veterans General Hospital-Kaohsiung, Taiwan, R.O.C.
Lin
C Y
CY
Kuo-Tai
J
J
Yuan
L
L
Chang
H J
HJ
D000328:Adult; D017548:Echocardiography, Transesophageal; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies