Passlick B, Born C, Sklarek J, Zoller J, Thetter O
Thoraxchirurgische Abteilung, Zentralkrankenhaus Gauting.
Zentralbl Chir. 1997;122(8):633-6.
With only a few exceptions every pulmonary nodule of unknown dignity has to be clarified by biopsy. Aim of the present study was to analyze the usefulness of minimal invasive thoracic surgery in patients with indeterminate pulmonary lesions.
In the study included were 121 patients (67 male/54 female), who were primarily treated by minimal-invasive surgery during the period 1992-1995. Preoperatively, a single pulmonary nodule was diagnosed in 89 patients. 32 patients had two or more lesions.
Using the minimal invasive approach a pulmonary nodule was successfully localized and resected in 83 (68.5%) patients. In 33 patients the operation was classified as diagnostic, in 36 patients benign or inflammatory tumors were completely resected and in 14 patients palliative resections of malignant tumors were performed. Overall, an extension of the operative approach was necessary in 38 (31.5%) of the patients. In 23 patients a "mini-thoracotomy" (< 5 cm) was used to localize the nodule. A standard thoracotomy was performed in 15 patients, mostly because of massive adhesions.
The minimal invasive approach has become a routine procedure in thoracic surgery and is extremely useful in the diagnosis of indeterminate pulmonary nodules.
除少数例外情况，每个性质不明的肺结节都必须通过活检来明确。本研究的目的是分析微创胸外科手术在肺部病变性质不确定患者中的应用价值。
本研究纳入了1992年至1995年期间接受微创外科手术治疗的121例患者（67例男性/54例女性）。术前，89例患者诊断为单个肺结节。32例患者有两个或更多病灶。
采用微创方法，83例（68.5%）患者的肺结节成功定位并切除。33例患者的手术被归类为诊断性手术，36例患者的良性或炎性肿瘤被完全切除，14例患者进行了恶性肿瘤的姑息性切除。总体而言，38例（31.5%）患者需要扩大手术方式。23例患者采用“小切口开胸术”（<5cm）来定位结节。15例患者进行了标准开胸手术，主要是因为存在大量粘连。
微创方法已成为胸外科的常规手术，在肺部病变性质不确定的诊断中非常有用。
