[Clinical Study of Surgical Treatment of Non-small Cell Lung Cancer  10 mm or Less in Diameter Under Video-assisted Thoracoscopy].
BACKGROUND
The reasonable operational manner of non-small cell lung cancer (NSCLC) in early stage is in dispute. This clinical study is to investigate the operational manner of NSCLC 10 mm or less in diameter.


METHODS
The clinical datas of 46 cases with NSCLC 10 mm or less in diameter were retrospectively analyzed in our hospital from July 2013 to March 2016. Thin-section computed tomography (CT) was done on all cases with 46 pulmonary nodules (5 solid nodules, 23 mGGOs and 18 pGGOs). Lobectomy, wedge resection and segmentectomy with lymph node dissection may be performed in patients according to age or heart and lung function. CT-guided Hook-wire precise localization was done on 7 cases.


RESULTS
Lobectomy and systematic lymph node dissection under video-assisted thoracic surgery (VATS) were performed in patients with 23 pulmonary nodules (15 mGGOs, 4 pGGOs and 4 solid nodules ), among wich, only one patient with N2 lymph node matastasis was found. Wedge resection and selective lymph node dissection under VATS were done in patients with 5 pulmonary nodules (2 mGGOs and 3 pGGOs), and segmentectomy and selective lymph node dissection under VATS were done in patients with 4 pulmonary nodules (2 mGGOs and 2 pGGOs), among wich, no patient with lymph node matastasis was found. CT-guided Hook-wire precise localization was done successfully on 7 cases.


CONCLUSIONS
Usually NSCLC with pGGO and mGGO nodules 10 mm or less in diameter has no lymph node metastasis, therefore, systematic lymph node dissection may be not necessary. Selective lymph node dissection or systematic lymph node dissection should be performed in patients with solid nodules 10 mm or less in diameter. Wedge resection and segmentectomy may be performed in patients with advanced age or lower heart and lung function. The preoperative CT-guided Hook-wire localization for pulmonary nodules particularly for GGOs is an effective and safe technique to assist VATS resection of the GGOs.
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Tong
T
Wang
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Shaohua
S
Ma
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Tiansheng
T
Yan
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Jintao
J
Song
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Keyi
K
Wang
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Wei
W
He
Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China.
Jie
J
Bai
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted; D047368:Tumor Burden; D055815:Young Adult