title: Safe and effective minimally invasive approaches for small ground glass opacity.
abstract: BACKGROUND
  Popularized computed tomography physical check up results in an increasing number of patients with ground glass opacity (GCO) lesions of which management has not been established yet.
  
  
  METHODS
  From January 2004 to December 2008, 738 patients underwent pulmonary resection for primary lung cancer, and 96 (13.0%) with resected GGO lesions were included in this study. Pure GGO lesions sized less than 10 mm are monitored until they grow bigger or develop a core. Three-port video-assisted thoracic lobectomy with systematic lymph node dissection is indicated when the lesion diameter exceeds 15 mm or is invasive, and segmentectomy is indicated when the tumor diameter is 10 to 15 mm. Wedge resection is indicated when the tumor is peripherally located.
  
  
  RESULTS
  There was no procedurally related mortality or morbidity. There were 9 papillary adenocarcinomas or invasive bronchioloalveolar carcinomas, 75 noninvasive bronchioloalveolar cell carcinomas, 7 atypical adenomatous hyperplasias, and 5 organizing pneumonias. No local recurrence was observed.
  
  
  CONCLUSIONS
  Several pathologies are included in GGO lesions, and the video-assisted thoracic approach seems to be one of the best options in their management.
authors.affiliation: Department of Thoracic Surgery, Toranomon Hospital, Tokyo, Japan. tkohno-ind@umin.ac.jp
authors.forename: Tadasu
authors.initials: T
authors.lastname: Kohno
authors.forename: Sakashi
authors.initials: S
authors.lastname: Fujimori
authors.forename: Kazuma
authors.initials: K
authors.lastname: Kishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujii
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed