Current tendencies in diagnostics and treatment of peripheral benign lung tumors

Abstract

The OBJECTIVE was to estimate clinical characteristics, diagnostic possibilities of computed tomography, minimally invasive methods of treatment of peripheral benign lung tumors.MATERIALS AND METHODS. Benign tumors were diagnosed in 311 (8.2 %) patients among 3789 people with bronchopulmonary neoplasms. A comparative assessment of the results of diagnostics and treatment of two groups of patients was carried out. The first group included 103 patients treated from 2003 to 2009, the second one – 128 patients treated from 2013–2020. 219 (94.8 %) patients were operated on. RESULTS. Benign lung tumors were more often detected at the age of 40-60 years – in 143 (61.9%) patients. The majority (184 patients, 79.6%) had no complaints. In 208 (90 %) patients, tumors were diagnosed during fluorography studies. In the second group, multispiral computed tomography revealed tumors less than 10 mm in size in 38 % of cases. The histological type of tumors was determined during intraoperative express histological test. In the second group, the number of thoracoscopies increased from 2.2 to 43 %, and – thoracotomies decreased from 94.5 to 52.3 %, the number of stapler resections of the lungs doubled, and the number of tumor enucleation decreased by half (p<0.01). Thoracotomy was performed in case of deep tumor localization or large size of the tumor, it was impossible to find it endoscopically. Ten patients underwent lobectomy.CONCLUSION. Most peripheral benign lung tumors are asymptomatic. Computed tomography revealed tumors less than 1cm in size in 38 % of cases. To rule out malignancy, it is necessary to perform urgent surgery with an intraoperative express histological test. Thoracoscopy allows to remove surface peripheral tumors using the method of stapler resection.