The role of video-assisted thoracoscopic surgery in the diagnosis of the small peripheral pulmonary nodule.
BACKGROUND
The use of imaging techniques to detect small peripheral pulmonary nodules often results in a missed diagnosis. Thoracoscopy had limited application until recently, when advances in technology allowed thoracic surgeons greater visualization and mobility within the chest.


METHODS
Between September 1992 and June 1997, 81 patients were treated for small peripheral pulmonary nodules by pulmonary wedge excision using video-assisted thoracoscopic techniques. The patients were 39 men and 42 women with an average age of 59.5 years.


RESULTS
A definitive diagnosis was obtained in all cases. Malignancies were found in 44 patients (55%), which involved primary lung cancer in 28 patients and metastatic lesions in 16 patients. The rate of malignancy in nodules measuring 1 cm or less was 18%. There was no operative mortality or morbidity.


CONCLUSIONS
We conclude that video-assisted thoracoscopic lung biopsy is a more effective and less invasive diagnostic tool for small peripheral pulmonary nodules.
Murasugi
M
M
Department of Surgery I, School of Medicine, Tokyo Women's Medical University, 8-1 Kawadacho Shinjuku-ku, Tokyo 162-8666, Japan. murasugi@chi.twmu.ac.jp
Onuki
T
T
Ikeda
T
T
Kanzaki
M
M
Nitta
S
S
D005260:Female; D006801:Humans; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods / Q000592:standards*; D013906:Thoracoscopy / Q000379:methods