EFFICIENCY OF MINIMAL INVASIVE THORACIC-SURGERY IN THE DIAGNOSIS OF PULMONARY NODULES

Aim of the study: With only a few exceptions every pulmonary nodule of unknown dignity has to be clarified by biopsy. Aim of the present stu dy was to analyze the usefulness of minimal invasive thoracic surgery in patients with indeterminate pulmonary lesions. Methods: In the stud y included were 121 patients (67 male/54 female), who were primarily t reated by minimal-invasive surgery during the period 1992-1995. Preope ratively, a single pulmonary nodule was diagnosed in 89 patients. 32 p atients had two or more lesions. Results: Using the minimal invasive a pproach a pulmonary nodule localized and resected in 83 (68.5 %) VATS patients. In 33 patients the operation was classified in 36 patients b enign or tumors were completely resected and in 14 patients palliative resections of malignant tumors were performed. Overall, an extension of the operative approach was necessary in 38 (31.5 %) of the patients . In 23 patients a ''mini-thoracotomy'' (< 5 cm) was used to localize the nodule. A standard thoracotomy was performed in 15 patients, mostl y because of massive adhesions. Conclusions: The minimal invasive appr oach has become a routine procedure in thoracic surgery and is extreme ly useful in the diagnosis of indeterminate pulmonary nodules.