[Video-assisted thoracoscopy for resecting solitary pulmonary nodules]

The objective of this study was to evaluate the usefulness of video assisted thoracoscopy in the resection of solitary pulmonary nodules. Thirty-three patients with solitary pulmonary nodules diagnosed by video assisted thoracoscopy were enrolled prospectively. A preoperative computed tomography scan was obtained for each patient. Harpoons were implanted preoperatively to locate the lesion in patients whose tumors were in the parenchyma. When endoscopic resection proved impossible in five patients, the surgeon resorted to thoracotomy. All were diagnosed after the procedure. One was a case of pulmonary lymphoma, 2 were primary adenocarcinomas of the lung, 2 were oat-cell cancers, 1 was Wegener's disease, 4 were tuberculomas, 3 involved pulmonary infarction and 20 were single pulmonary metastases. Patients who needed thoracotomy required more days of postsurgical drainage (p < 0.05). The size of resected nodules ranged from 0.4 to 6 centimeters. Preoperative positron emission tomographs were available for four patients. No perioperative (< 30 days) mortality occurred and morbidity consisted of one case of prolonged airway leak (> 7 days). Use of video-assisted thoracoscopy reduced perioperative morbidity and hospital stay.