Management of the solitary pulmonary nodule: role of thoracoscopy in diagnosis and therapy.

OBJECTIVES The solitary pulmonary nodule remains a common clinical problem. The essential question is whether the lesion is malignant or not. This discussion presents the clinical practice and looks at the problem. DESIGN Didactic. SETTING Academic tertiary-care hospital. PATIENTS Prospective thoracic database. INTERVENTIONS Minimally invasive technique. RESULTS The workup and treatment of the solitary pulmonary nodule is presented with particular emphasis on the role of minimally invasive techniques. A small single-institution series is referenced. CONCLUSIONS The approach is safe and highly effective in diagnosing and often in treating solitary pulmonary nodules.

[1]  P. Templeton,et al.  Needle/wire lung nodule localization for thoracoscopic resection. , 1993, Chest.

[2]  K. H. Mayer,et al.  VATS (video-assisted thoracic surgery) of undefined pulmonary nodules. Preoperative evaluation of videoendoscopic resectability. , 1994, Chest.

[3]  L. Santambrogio,et al.  Videothoracoscopy versus thoracotomy for the diagnosis of the indeterminate solitary pulmonary nodule. , 1995, The Annals of thoracic surgery.

[4]  A. Celler,et al.  Pulmonary nodules: differential diagnosis using 18F-fluorodeoxyglucose single-photon emission computed tomography. , 1997, AJR. American journal of roentgenology.

[5]  P. Schnyder,et al.  CT-guided localizations of pulmonary nodules with methylene blue injections for thoracoscopic resections. , 1994, Chest.

[6]  R. Munden,et al.  Small pulmonary lesions detected at CT: clinical importance. , 1997, Radiology.

[7]  J. Bishop,et al.  The cost of diagnosis: a comparison of four different strategies in the workup of solitary radiographic lung lesions. , 1997, Chest.

[8]  E. W. Wilkins.  The asymptomatic isolated pulmonary nodule. , 1955, The New England journal of medicine.

[9]  M. Mack,et al.  Cost analysis for thoracoscopy: thoracoscopic wedge resection. , 1993, The Annals of thoracic surgery.

[10]  S J Mentzer,et al.  The safety and versatility of video-thoracoscopy: a prospective analysis of 895 consecutive cases. , 1996, Journal of the American College of Surgeons.

[11]  S. Gasparini,et al.  Integration of transbronchial and percutaneous approach in the diagnosis of peripheral pulmonary nodules or masses. Experience with 1,027 consecutive cases. , 1995, Chest.

[12]  J. V. van Engelshoven,et al.  The value of conventional radiography and computed tomography (CT) in diagnosis of pulmonary hamartoma. , 1983, Rontgen-Blatter; Zeitschrift fur Rontgen-Technik und medizinisch-wissenschaftliche Photographie.