Video-assisted thoracoscopic resection of pulmonary lesions.
OBJECTIVE
To determine the role of video-assisted thoracoscopic resection in the diagnosis of benign or malignant peripheral pulmonary lesions.


METHODS
In 157 patients, between 1996 and 2001, video-assisted thoracoscopy was used to remove a pulmonary lesion. Conversion rate, complications and histology are presented.


RESULTS
In 21 patients, conversion to a thoracotomy was necessary, four times because the pulmonary lesion was malignant and seventeen times due to technical difficulties. In patients without any previous history of malignant disease (n=100), 80% of the lesions were benign. In patients with malignant pulmonary lesions (n=21), curative resection was possible, 3 through VATS and 4 through thoracotomy. Pulmonary lesions in patients with a previous history of malignant disease were malignant in 42 patients. Curative VATS resection of a solitary lesion was performed in 9 patients, in 10 patients thoracotomy was necessary to remove multiple lesions.


CONCLUSIONS
With a pre-operative selection of the patients the rate of secondary thoracotomies due to bronchial carcinoma is low (4%). In patients with a previous history of malignant disease, 22% of the pulmonary lesions are benign. VATS is a safe diagnostic method, with little discomfort for the patient.
Ludwig
C
C
Department of Thoracic Surgery, University Hospital, Freiburg, Germany. ludwig@ch11.ukl.uni-freiburg.de
Zeitoun
M
M
Stoelben
E
E
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D002283:Carcinoma, Bronchogenic / Q000601:surgery; D002812:Chondroma / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000601:surgery; D011030:Pneumothorax / Q000209:etiology; D011183:Postoperative Complications; D003074:Solitary Pulmonary Nodule / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013908:Thoracotomy