Thoracoscopy for the diagnosis of the indeterminate solitary pulmonary nodule

Mack, Michael J.; Hazelrigg, Stephen R.; Landreneau, Rodney J.; Acuff, Tea E.

doi:10.1016/0003-4975(93)90339-j

Cited by 237 publications

(101 citation statements)

References 24 publications

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“…Twenty-eight (34%) of 82 subjects with thoracotomy or VATS procedures for known or suspected lung cancer ended in a noncancer diagnosis, a result somewhat better than typical practice, where 50% of thoracic surgical procedures to exclude malignancy in a lung nodule do not find cancer (23,24). Even after taking account of subjects who obtained thoracotomy or VATS against the primary recommendation of study clinicians (Table 3), the frequency of resection for benign nodules, as observed under our protocol, is higher than generally desired.…”

Section: Discussionmentioning

confidence: 93%

The Pittsburgh Lung Screening Study (PLuSS)

Wilson¹,

Weissfeld²,

Fuhrman³

et al. 2008

Am J Respir Crit Care Med

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204

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Section: Discussionmentioning

confidence: 93%

The Pittsburgh Lung Screening Study (PLuSS)

Wilson¹,

Weissfeld²,

Fuhrman³

et al. 2008

Am J Respir Crit Care Med

Self Cite

204

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“…In two small older studies, there were no fatal complications; nonfatal complications occurred in about 5% of patients. 109,110 More recent reports are diffi cult to interpret because they combine results for diagnostic VATS with VATS lobectomy, often in patients with severe comorbid conditions.…”

Section: Surgical Diagnosismentioning

confidence: 99%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

1,163

1,089

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we suggest that no additional diagnostic evaluation need be performed (Grade 2C) .Remark : This recommendation applies only to solid nodules. For guidance about follow-up of subsolid nodules, see Recommendations 6.5.1 to 6.5.4 . 2.3.3.In the individual with an indeterminate nodule that is identifi ed by chest radiography, we recommend that CT of the chest should be performed (preferably with thin sections Objectives: The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods: We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the "Methodology for Development of Guidelines for Lung Cancer" in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results: We formulated recommendations for evaluating solid pulmonary nodules that measure . 8 mm in diameter, solid nodules that measure Յ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefi ts and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions: Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. CHEST 2013; 143(5)(Suppl):e93S-e120SAbbreviations: AAH 5 atypical adenomatous hyperplasia; ACCP 5 American College of Chest Physicians; AIS 5 adenocarcinoma in situ; EBUS 5 endobronchial ultrasound; ENB 5 electromagnetic navigation bronchoscopy; FDG 5 fl uorodeoxyglucose; HU 5 Hounsfi eld unit; LR 5 likelihood ratio; SPECT 5 single-photon emission CT; TBB 5 transbronchial biopsy; TTNB 5 transthoracic needle biopsy; VATS 5 video-assisted thoracic surgery; VBN 5 virtual bronchoscopy navigation; VDT 5 volume doubling time

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“…In the experience of the Lungenklinik Heckeshorn, Berlin, Germany [12], localised lung diseases declined from 12 (1971-1979) to 6 (1980-1988) to 3% (1995)(1996), whereas chest wall lesions which were 6 (1971-1979) and 5% (1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988), reduced to 2.5% in 1995-1996. For these lesions, VATS is today the procedure of choice as it allows the diagnosis and removal of the lesion [63,64], sometimes preceded by transthoracic needle aspiration [65].…”

Section: Indicationsmentioning

confidence: 99%

Advanced techniques in medical thoracoscopy

Tassi¹,

Davies²,

Noppen³

2006

Eur Respir J

103

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For expert pulmonologists, advanced procedures in medical thoracoscopy are the nonroutine and more complex applications of the method. The main current indications are the treatment of infected pleural space, forceps lung biopsy and sympathectomy.In parapneumonic effusions and empyema, medical thoracoscopy is as a drainage procedure, intermediate between tube thoracostomy and video-assisted thoracoscopic surgery (VATS), which is efficient, significantly lower in cost and avoids surgical thoracoscopy under general anaesthesia. It is essential that it is performed early in the course of the disease and is particularly advisable for frail patients at high surgical risk.The efficacy of forceps lung biopsy has been demonstrated in diffuse lung diseases, whereas results in localised lung diseases and chest-wall lesions have been less positive. However, VATS is currently the preferred approach for these indications. The technique still maintains its efficacy for visceral pleura and peripheral lung biopsy, in particular in the presence of pleural effusion and lung disorders.At the present time, thoracoscopic sympathectomy is minimally invasive and is an accepted intervention for patients with a variety of autonomous nervous system disturbances. Essential hyperhidrosis patients, and well-selected patients with other disorders, can be helped with this procedure, which can also be performed by interventional pulmonologists.

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Thoracoscopy for the diagnosis of the indeterminate solitary pulmonary nodule

Cited by 237 publications

References 24 publications

The Pittsburgh Lung Screening Study (PLuSS)

The Pittsburgh Lung Screening Study (PLuSS)

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Advanced techniques in medical thoracoscopy

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