THORACOSCOPIC EVALUATION OF HISTOLOGICALLY CYTOLOGICALLY PROVEN OR SUSPECTED LUNG-CANCER - A VATS EXPLORATION/

To evaluate the diagnostic value of video-assisted thoracic surgery (V ATS), VATS exploration was performed in 135 patients with histological ly/cytologically proven or suspected lung cancer. In 31 patients with pulmonary nodules suspected to be lung cancer, VATS exploration was in tended to determine their histology by wedge resection. A histological diagnosis was made in all of the patients: 12 lung cancers (38.7%), 1 2 inflammatory granulomas (38.7%), four hamartomas (12.9%), and three others. VATS exploration (staging) was performed in 116 surgical candi dates with documented lung cancer, including the 12 patients diagnosed by VATS wedge resection. Inoperable factors were demonstrated by this procedure in five patients (4.3%): malignant effusion without dissemi nation in three, malignant effusion with extensive dissemination in on e, and extensive dissemination without effusion in one. Furthermore, N 2 nodal metastasis al Botallo's ligament was demonstrated by this proc edure in two patients, which mel the eligibility criteria for a clinic al study. Although the documented number of patients was relatively sm all, VATS exploration obviated the need for painful thoracotomy, selec ting better treatment and for evaluating eligibility criteria for pros pective clinical trials. The results suggest that this procedure is us eful in candidates for lung cancer surgery. (C) 1997 Elsevier Science Ireland Ltd.