Surgical management of ground glass opacities of the lung

Abstract

Emerging evidence for the efficacy of low‐dose CT thorax screening for lung cancer is undoubtedly good news for patients. However, the by‐product is increasing incidental detection of lung lesions know as ground‐glass opacities (GGOs). Because these may or may not develop into lung cancer, a number of guidelines currently exist to help clinicians decide how to manage them. These guidelines are characterized by a reliance on CT imaging alone, an inherent aversion to surgery, and a failure to recognize the possibility of variance in GGO pathology between populations in different parts of the world. As a result, surgeons in particular are inadequately served by these guidelines. This article explores how recent advanced in thoracic surgery may play important roles in shaping GGO management, and how surgery may need to feature more prominently in future guidelines.

Should sublobar resection be offered for screening-detected lung nodules?

“…The advantage of sublobar resection is of course that minimizing the lung volume resected should in turn minimize the harm and morbidity caused to the patient. A good volume of evidence has been published demonstrating that compared to lobectomy a sublobar resection can better preserve lung function (in terms of spirometry results, pulmonary gas exchange, anaerobic threshold, and so on), and also reduce post-operative morbidity (62,(65)(66)(67). This is especially important in elderly and frail patients who may not tolerate a lobectomy (68,69).…”