Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection

Updates Surg. 2021 Aug;73(4):1559-1566. doi: 10.1007/s13304-020-00953-w. Epub 2021 Jan 4.

Abstract

Since the introduction of lung nodule radio-guided localization, multiport video-assisted thoracoscopic surgery resection has been widely described. To date, only one series has reported the use of uniportal approach. Our objective is to describe the experience of a single institution of lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection. Retrospective cohort study based on data from medical records of patients between May 2012 and April 2019. Twenty-four patients were included, 13 were women (54.2%) with a median age of 59.5 years (range 19 and 81 years). Median nodule size was 7 mm (range 3-12 mm) and 19 (79.2%) patients had single lung nodule. The main indication was sub-centimetric nodule in 22 (91.6%) patients followed by a deep localization in 10 (41.6%) patients and sub-solid nodule in 9 (37.5%) patients. Median surgical time was 102.5 min (range 55-160 min). 4 (16.6%) patients had malignant neoplasm of the lung, 10 (41.7%) patients had lung metastases and 10 (41.7%) patients had benign lung lesions. The success rate found was 95.8%. Concordance analysis between palpation of the pulmonary nodule and the presence of the nodule in the histopathology was rated as poor, kappa value - 0.71 (P = 0.186) and between the resection of the pulmonary nodule according to the presence of the nodule in the pathology report was rated as good, Kappa value 0.625 (P = 0.001). Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection has a similar success rate and complications to those described by multiport video-assisted thoracoscopic surgery resections.

Keywords: Lung neoplasms; Multiple pulmonary nodules; Solitary pulmonary nodule; Thoracic surgery; Video-Assisted.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lung
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / surgery
  • Middle Aged
  • Retrospective Studies
  • Solitary Pulmonary Nodule* / diagnostic imaging
  • Solitary Pulmonary Nodule* / surgery
  • Thoracic Surgery, Video-Assisted
  • Tomography, X-Ray Computed
  • Young Adult