The Role of Video-Assisted Thoracoscopic Surgery in the Diagnosis of the Small Peripheral Pulmonary Nodule

Murasugi, Masahide; Onuki, Takamasa; Ikeda, Tomosumi; Kanzaki, Masato; Nitta, Sumio

doi:10.1007/s004640090084

Cited by 30 publications

(16 citation statements)

References 7 publications

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“…The inability to find the nodule is noted in almost all published reports, and its impact ranges from 0.8% [45] to 7.5% [6]. Without the possibility of lung palpation and using only the video system, the main difficulty of this procedure is the detection of very small nodules [47] and their resection when they are located deep in the parenchyma. To solve this problem, many technical solutions have been proposed: preoperative injection of methylene blue [6,33,87] or colored collagen [54] into the lesion, different methods of preoperative positioning of a wire hook under CT guidance [6,17,20,24,46,62], and intraoperative ultrasonography [46].…”

Section: Wedge Resectionmentioning

confidence: 94%

“…Postoperative morbidity in the largest series ranges from 3.6 % [45] to 11 % [47]. Some deaths not related to surgical technique are reported [1,6,16,30].…”

Section: Wedge Resectionmentioning

confidence: 98%

“…Therefore, it may be better to consider the use of mini-thoracotomy in such cases. Other intraoperative complications that have led to conversion to thoracotomy are pleural adhesions [6], bleeding [1,6,24], stapler malfunction [1], and air leak [6,47].…”

Section: Wedge Resectionmentioning

confidence: 99%

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Video-assisted thoracic surgery (VATS) of the lung

et al. 2007

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The analysis of the literature and our experience show that VATS is a reliable approach to the diagnosis and treatment of pulmonary diseases with low complication rate. To further reduce intraoperative and postoperative morbidity, however, it is necessary to select the patients carefully, to adhere strictly to oncological surgical principles, and to adopt a meticulous technique. Although conversion to open surgery represents failure of VATS, it is mandatory when the procedure is not completely safe.

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Section: Wedge Resectionmentioning

confidence: 94%

“…Postoperative morbidity in the largest series ranges from 3.6 % [45] to 11 % [47]. Some deaths not related to surgical technique are reported [1,6,16,30].…”

Section: Wedge Resectionmentioning

confidence: 98%

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Video-assisted thoracic surgery (VATS) of the lung

et al. 2007

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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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“…Controversy regarding its use is based on: (a) the falsenegative rate, which is as high as 29% [17] and approaching 60% among patients with nonspecific benign cytological findings [18]; (b) an incidence of pneumothorax of up to 30%, although only a minority of patients require further treatment [17][18][19][20][21][22] (chest tube in 5%-7% of cases developing pneumothorax); and (c) philosophically, many physicians consider the technique as superfluous and expensive and as an intermediate step with potential morbidity and only a small impact on definitive treatment [23][24][25].…”

Section: Diagnosis Of Indeterminate Pulmonary Nodulesmentioning

confidence: 99%

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Solli

Spaggiari

2007

The Oncologist

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After completing this course, the reader will be able to:1. Discuss the role of thoracoscopy in the evaluation of pulmonary nodules and pleural effusion.2. Describe the role of thoracoscopy in the staging of lung cancer.3. Discuss the role of thoracoscopy in surgical resection of early-stage lung cancer.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThe term video-assisted thoracic surgery (VATS) is used to describe a modern minimally invasive surgical technique that nowadays represents a valid alternative to open procedures (i.e., thoracotomy) for many chest diseases. The VATS approach is presently used in many intrathoracic disorders, but while well established in benign chest disease, its role continues to evolve regarding the management of lung cancer. It is currently considered for the evaluation and treatment of suspected (or known) pleural effusion and in the diagnosis of indeterminate pulmonary nodules, and it has a complementary role to standard cervical mediastinoscopy in the invasive staging of mediastinal lymph nodes. It has also become an accepted approach for resection of peripheral early-stage lung cancer (stage I) in many centers worldwide and considerable experience has been accumulated in respect to this field, but absolute indications have yet to be firmly defined. This paper reviews indications and current data regarding minimally invasive approaches for the staging and treatment of lung cancer.

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The Role of Video-Assisted Thoracoscopic Surgery in the Diagnosis of the Small Peripheral Pulmonary Nodule

Abstract: We conclude that video-assisted thoracoscopic lung biopsy is a more effective and less invasive diagnostic tool for small peripheral pulmonary nodules.

Cited by 30 publications

References 7 publications

Video-assisted thoracic surgery (VATS) of the lung

Video-assisted thoracic surgery (VATS) of the lung

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

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