Diagnosing the indeterminate pulmonary nodule: Percutaneous biopsy versus thoracoscopy

Mitruka, Surindra N.; Landreneau, Rodney J.; Mack, Michael J.; Fetterman, Lynda S.; Gammie, James S.; Bartley, Susan; Sutherland, Shannon R.; Bowers, Claudia M.; Keenan, Robert J.; Ferson, Peter F.; Weyant, Robert J.

doi:10.1016/s0039-6060(05)80035-2

Cited by 86 publications

(36 citation statements)

References 18 publications

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“…The importance of diagnosing a solitary pulmonary nodule derives from the high risk of malignancy [4]. Video-thoracoscopy is being increasingly used in the diagnosis of pulmonary nodules.…”

Section: Discussionmentioning

confidence: 99%

Prospective study on video-assisted thoracoscopic surgery in the resection of pulmonary nodules: 209 cases from the Spanish Video-Assisted Thoracic Surgery Study Group

Jiménez

2001

European Journal of Cardio-Thoracic Surgery

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Objective: The diagnosis of pulmonary nodules has become one of the main indications of video-assisted thoracoscopic surgery (VATS), especially for small nodules not accessible by bronchoscopy or by percutaneous transthoracic needle aspiration. In this study we evaluate the indications, diagnostic safety, complications, and technical dif®culty of VATS in the diagnosis of pulmonary nodules in Spain. Materials and methods: We conducted a prospective study of 209 patients with one or more pulmonary nodules from a group of Spanish thoracic surgery divisions (The Spanish Video-assisted Thoracic Surgery Study Group). Data was collected and evaluated on variables contained on a questionnaire including demographic information, characteristics of the nodules, identi®cation methods, surgical technique, morbidity and mortality rates, and diagnostic yield. Results: The mean size of the nodules was 1.9 cm (range 0.3±5 cm). A total of 93.3% were peripheral. A diagnosis was established in 100% of the cases. In this study, 51.1% of lesions were benign and 48.8% were malignant. In 16.3% of cases, a conversion to thoracotomy was needed. The morbidity was 9.6% and the mortality 0.5%. We found a relationship between the size of a nodule and a diagnosis of malignancy (P 0:019) and between a central location and a need to convert to thoracotomy (P 0:002). Patients with nodules .2 cm had a greater risk of complications (P 0:0001). Conclusions: In the diagnosis of pulmonary nodules, VATS has a speci®city of 100% and a low mortality rate. The probability of developing complications is higher when the nodule is . 2 cm. q

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“…The importance of diagnosing a solitary pulmonary nodule derives from the high risk of malignancy [4]. Video-thoracoscopy is being increasingly used in the diagnosis of pulmonary nodules.…”

Section: Discussionmentioning

confidence: 99%

Prospective study on video-assisted thoracoscopic surgery in the resection of pulmonary nodules: 209 cases from the Spanish Video-Assisted Thoracic Surgery Study Group

Jiménez

2001

European Journal of Cardio-Thoracic Surgery

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“…2 When the lung is the main tumor site, this definition also includes multifocal mucosa-associated lymphoid tissue (MALT) NHL and pulmonary involvement with satellite nodes (hilar or mediastinal). 3 Diagnosis requires biopsies by invasive methods such as transbronchial, percutaneous, or even surgical lung biopsies [4][5][6] for both histologic analysis and immunohistologic staining. More than 95% of primary pulmonary lymphomas are B-NHL 7,8 with a predominance of low-grade lymphomas (75%-80%), most of which consist of MALT lymphomas.…”

Section: Introductionmentioning

confidence: 99%

Clonality analysis of alveolar B lymphocytes contributes to the diagnostic strategy in clinical suspicion of pulmonary lymphoma

Zompì

Couderc

Cadranel

et al. 2004

Blood

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“…Surgical lung biopsy by video-assisted thoracic surgery (VATS) has demonstrated proven accuracy and has become an increasingly accepted approach for management of solitary pulmonary nodules [3][4][5][6]. General anesthesia with one-lung ventilation, is deemed mandatory for pulmonary VATS resection although several adverse effects can derive from this type of anesthesia including the development of atelectasis in both the dependent and nondependent lung, and the so called ventilator-induced lung injury [7].…”

mentioning

confidence: 99%

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

Pompeo¹,

Mineo²,

Rogliani³

et al. 2004

The Annals of Thoracic Surgery

222

171

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Background. General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic pulmonary resection. We assessed in a randomized study the feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules.Methods. Between March 2001 and February 2003, 60 patients were randomized into two 30-patients arms: a general anesthesia arm entailing double-lumen intubation and thoracic epidural anesthesia (control group); and an awake arm entailing sole thoracic epidural anesthesia at T4-T5 (awake group). Anesthesia time; operative time; global operating room time; patient satisfaction with the anesthesia and technical feasibility scored into 4 grades (from 1 ‫؍‬ poor to 4 ‫؍‬ excellent); visual analog pain score (VAS), nursing care (number of patient calls per day), 24 hours changes in arterial oxygenation (⌬PaO 2 ), and hospital stay were assessed.Results. There was no mortality. There was no difference

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Diagnosing the indeterminate pulmonary nodule: Percutaneous biopsy versus thoracoscopy

Cited by 86 publications

References 18 publications

Prospective study on video-assisted thoracoscopic surgery in the resection of pulmonary nodules: 209 cases from the Spanish Video-Assisted Thoracic Surgery Study Group

Prospective study on video-assisted thoracoscopic surgery in the resection of pulmonary nodules: 209 cases from the Spanish Video-Assisted Thoracic Surgery Study Group

Clonality analysis of alveolar B lymphocytes contributes to the diagnostic strategy in clinical suspicion of pulmonary lymphoma

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

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