H. Asamura et al., THORACOSCOPIC EVALUATION OF HISTOLOGICALLY CYTOLOGICALLY PROVEN OR SUSPECTED LUNG-CANCER - A VATS EXPLORATION/, Lung cancer, 16(2-3), 1997, pp. 183-190
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.