Abstract

JORDAN, Pablo et al. Manejo del nódulo pulmonar solitario por cirugía videotoracoscópica. Rev. amer. med. respiratoria [online]. 2011, vol.11, n.2, pp.63-73. ISSN 1852-236X.

Introduction: The objective of this study was to determinate the different etiologies of solitary pulmonary nodules surgically resected; and to establish the diagnostic rentability and rate of complications in videothoracoscopic resections of the nodules. Methods: We evaluated 483 patients with solitary nodules who were surgically resected in the Buenos Aires British Hospital between 1987 and 2008. The inclution criteria were: intraparenchymal lung lesion under 3 cm, in the absence of atelectasis or pneumonia and /or lymph nodes. Results: The pathological examination of the resected nodules had show 342 (70.8%) of malignant lesions and 141 (29.2%) of benign lesions. Among which granulomatous disease (48.2%) and hamartomas (22.7%) were the main causes. Patients with a malignant lesions were older and had larger size (p = <0.001) than patients with benign lesions. However, there was no significant difference between patients with tobacco exposure (p=0.981) and a history of a previous malignancy (p=0.981) Video-assisted thoracoscopic surgery (VATS) was performed in 238 patients (49.3%) Among the benign lesions the conversion to thoracotomy was performed in 7cases (8.3%). The causes were: the inability to locate the lesion or the need of extension of the resection. Complications associated to resection videothoracoscopic appeared in 8 patients (3.36%) Conclusions: The VATS is a procedure of very low morbimortality in the resection of benign nodules. The age of the patient and the size of the pulmonary nodule were reliable factors to predict the malignant histology.

Keywords : Videothoracoscopic surgery; Benign pulmonary nodules; Solitary pulmonary nodules.

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