Video assisted thoracoscopic surgery in patients with small peripheral pulmonary tumors

Despite the existence of many diagnostic methods such as bronchoscopy, computerized tomographic (CT) scan, magnetic resonance imaging (MRI) and transthoracic aspiration biopsy, small peripheral pulmonary lesions cannot always be verified. With this communication we describe our experience with the video-assisted thoracoscopic surgery (VATS) in the diagnosis and treatment of small peripheral pulmonary tumors.

The study included 22 patients evaluated and treated with VATS because of small peripheral lung lesions. The patients were operated on at the Clinic of Thoracoabdominal Surgery of the Medical University, Plovdiv, during a period of 6 years (1997-2002).

Pulmonary hamartoma was found in 8 patients, solitary metastasis in 8, primary lung cancer in 4 and tuberculoma in 2. Twenty patients underwent partial pulmonary resection using VATS, and in 2 patients VATS was turned into thoracotomy, because the tumor was situated deeply in the pulmonary parenchyma and was not found with VATS. In 4 of the patients thoracotomy and lobectomy were performed because of histological confirmation of primary lung cancer.

VATS is a safe, effective and cost-effective method for the diagnosis and treatment of peripheral pulmonary tumors.