[Video thoracoscopy of pulmonary nodules. Can one avoid preoperative markers?].
For a period of 35 months, 50 patients presenting with a total of 61 peripheral pulmonary nodules were operated on under videothoracoscopy. As a matter of principle none of these nodules were marked radiologically pre-operatively. All the scanners were reviewed retrospectively by a radiologist and a thoracic surgeon without knowing the results of the thoracoscopic intervention: 23 of these patients on the evidence would have quite obviously required preoperative marking (group I), and 27 would have been presented for direct thoracoscopy (group II). In group I there was only one group of nodules which could not be localised and by necessity, a thoracotomy was required. In group II, two nodules could only be localised thanks to a mino-thoracotomy. The level of failure was between 4 and 7%, and was identical to that found in the literature for different techniques of pre-operative radiological marking: these techniques were often complicated by a pneumothorax and intrapulmonary haemorrhage. These techniques for marking are used extensively. Prospective studies based on precise and complete criteria should enable better definition of rare cases which might benefit.
Debrosse
D
D
Service de Chirurgie Thoracique, Hôpital Laennec, Paris.
Riquet
M
M
Deslandes
P
P
Dujon
A
A
Le Pimpec-Barthes
F
F
Fourquier
P
P
Debesse
B
B
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed; D014741:Video Recording
Vidéothoracoscopie des nodules pulmonaires. Peut-on se passer d'un repérage pré-opératoire?