THORACOSCOPIC FINE-NEEDLE ASPIRATION OF SOLITARY PULMONARY NODULES

To determine the diagnostic efficacy of thoracoscopic fine-needle aspi ration (FNA) of solitary pulmonary nodules suspicious for lung cancer, we performed intraoperative thoracoscopic FNA for diagnostic purposes in 8 consecutive patients with peripheral solitary pulmonary nodules suspicious for lung cancer. Thoracoscopic FNA yielded an accurate diag nosis in all cases. There were 5 cases of non-small cell lung carcinom a, 1 small cell lung carcinoma, 1 renal carcinoma metastasis, and 1 in flammatory nodule. Results of FNA were obtained in less than 10 minute s in 6 cases. Maximum time to diagnosis was 20 minutes. The surgical p rocedure was expedited in the 6 cases of lung cancer because lobectomy followed FNA rather than the performance of a diagnostic wedge resect ion. A minor hematoma after FNA was the single complication. Thoracosc opic FNA yielded a prompt and accurate diagnosis of peripheral solitar y pulmonary nodules. Thoracoscopic FNA should be considered as an alte rnative to preoperative percutaneous FNA, which risks pneumothorax and patient discomfort. In cases of lung cancer, thoracoscopic FNA allows the surgeon to bypass a diagnostic wedge resection and to proceed wit h definitive lobectomy. (C) 1997 by The Society of Thoracic Surgeons.