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Video-assisted Thoracoscopic Resection of a Small Pulmonary Nodule after Computed Tomography-guided Localization with a Hook-wire System : Experience in 45 Consecutive Patients

Pittet, Olivier ; Christodoulou, Michel ; Pezzetta, Edgardo ; Schmidt, Sabine ; Schnyder, Pierre ; Ris, Hans-Beat

In: World Journal of Surgery, 2007, vol. 31, no. 3, p. 575-578

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    Titre
    • Video-assisted Thoracoscopic Resection of a Small Pulmonary Nodule after Computed Tomography-guided Localization with a Hook-wire System
      Experience in 45 Consecutive Patients
    Auteur
    • Pittet, Olivier. Division of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
    • Christodoulou, Michel. Division of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
    • Pezzetta, Edgardo. Division of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
    • Schmidt, Sabine. Department of Radiology, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
    • Schnyder, Pierre. Department of Radiology, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
    • Ris, Hans-Beat. Division of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • World Journal of Surgery, 2007, vol. 31, no. 3, p. 575-578. Springer-Verlag; www.springer-ny.com
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:312469
    Summary
    Background: This study is a single-institution validation of video-assisted thoracoscopic (VATS) resection of a small solitary pulmonary nodule (SPN) previously localized by a CT-guided hook-wire system in a consecutive series of 45 patients. Methods: The records of all patients undergoing VATS resection for SPN preoperatively localized by CT-guided a hook-wire system from January 2002 to December 2004 were assessed with respect to failure to localize the lesion by the hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of SPN. Results: Forty-five patients underwent 49 VATS resections, with simultaneous bilateral SPN resection performed in 4. Preoperative CT-guided hook-wire localization failed in two patients (4%). Conversion thoracotomy was necessary in two patients (4%) because it was not possible to resect the lesion by a VATS approach. The average operative time was 50 min. Postoperative complications occurred in 3 patients (6%), one hemothorax and two pneumonia. The mean hospital stay was 5 days (range: 2-18 days). Histological assessment revealed inflammatory disease in 17 patients (38%), metastasis in 17 (38%), non-small-cell lung cancer (NSCLC) in 4 (9%), lymphoma in 3 (6%), interstitial fibrosis in 2 (4%), histiocytoma in one (2%), and hamartoma in one (2%). Conclusions: Histological analysis of resected SPN revealed unexpected malignant disease in more than 50% of the patients indicating that histological clarification of SPN seems warranted. Video-assisted thoracoscopic resection of SPN previously localized by a CT-guided hook-wire system is related to a low conversion thoracotomy rate, a short operation time, and few postoperative complications, and it is well suited for the clarification of SPN