C Ludwig1, M Zeitoun, E Stoelben. 1. Department of Thoracic Surgery, University Hospital, Freiburg, Germany. ludwig@ch11.ukl.uni-freiburg.de
Abstract
AIMS: To determine the role of video-assisted thoracoscopic resection in the diagnosis of benign or malignant peripheral pulmonary lesions. PATIENTS AND METHOD: 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.
AIMS: To determine the role of video-assisted thoracoscopic resection in the diagnosis of benign or malignant peripheral pulmonary lesions. PATIENTS AND METHOD: 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.