Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Solli, Piergiorgio; Spaggiari, Lorenzo

doi:10.1634/theoncologist.12-10-1205

Cited by 15 publications

(9 citation statements)

References 85 publications

(89 reference statements)

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“…Given that around half the nodules detected are malignant, the quest for early detection has assumed growing importance. High-resolution helical CT scanning has enabled the diagnosis of more and smaller nodules, many of which represent a major diagnostic and therapeutic dilemma 40,41 . A number of factors point to the potential malignancy of solitary pulmonary nodules, including age, tobacco use, nodule size, demonstrable growth in the interval between consecutive examinations, and history of malignant tumors.…”

Section: Solitary Pulmonary Nodulementioning

confidence: 99%

Video-Assisted Surgery for Lung Cancer. State of the Art and Personal Experience

Loscertales

Jiménez-Merchán

Congregado

et al. 2009

Asian Cardiovasc Thorac Ann

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This paper reviews the role of videothoracoscopy in lung cancer, highlighting its utility in definitive staging, diagnosis, and treatment. We show exploratory videothoracoscopy to be the perfect technique for last-minute staging, looking for tumor invasion, especially parietal T3 and vascular T4 (due to videopericardioscopy), management of solitary pulmonary nodules, and the possibility of radical treatment with video-assisted thoracoscopic lobectomy. We perform an overview of the literature and analyze our experience of 1,381 patients with lung cancer. In 1,277 of them, the final decision on resectability was made by exploratory videothoracoscopy, including 91 by videopericardioscopy (only 30 were considered non-resectable on videopericardioscopy). Solitary pulmonary nodules were diagnosed in 382 cases (190 were cancer), and we performed 260 major lung resections by video-assisted thoracoscopic surgery (22 pneumonectomies, 238 lobectomies/bilobectomies).

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Section: Solitary Pulmonary Nodulementioning

confidence: 99%

Video-Assisted Surgery for Lung Cancer. State of the Art and Personal Experience

Loscertales

Jiménez-Merchán

Congregado

et al. 2009

Asian Cardiovasc Thorac Ann

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“…Die konventionelle Thorakotomie und zunehmend minimalinvasive Eingriffe ("video-assisted thoracic surgery", VATS) mit Resektion des SPR sind der "Goldstandard" der Diagnose und zugleich definitive Therapie in vielen, aber nicht in allen Fällen [24,29]. Wichtig bleibt hier zu betonen, dass sowohl die Empfehlungen der Fleischner Society als auch die davon abgeleiteten Empfehlungen der ACCP nur für Patienten mit zufällig gefundenen SPR gelten.…”

Section: Operationunclassified

Radiologische Abklärung pulmonaler Rundherde

Prosch

Mostbeck

2009

Pneumologe

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Solitäre pulmonale Rundherde (SPR) sind ein häufiges pneumologisches Problem. Bei der Abklä-rung von SPR müssen insbesondere maligne Rundherde zuverlässig von benignen Rundherden unterschieden werden. Das diagnostische Vorgehen richtet sich vor allem nach der Raucher-und Malignomanamnese, der Größe, der Begrenzung und der Computertomographie-(CT-)Morphologie der Herde. Ein benignes Verkalkungsmuster oder ein fehlendes Wachstum über 2 Jahre sind zuverlässige Zeichen benigner SPR. Bei kleinen SPR (≤8 mm) werden Verlaufskontrollen empfohlen, deren Intervall sich nach dem Risiko und der Größe der Herde richtet. Bei größeren SPR werden je nach Vortestwahrscheinlichkeit Verlaufskontrollen, eine dynamische CT oder Magnetresonanztomographie (MRT), eine 18-Fluordeoxyglukose-Positronenemissionstomographie (FDG-PET), die feingewebliche Abklärung oder eine operative Entfernung empfohlen. SchlüsselwörterSolitäre pulmonale Rundherde · Bronchialkarzinom · Computertomographie · Pulmonale Metastasen · Biopsie Radiological evaluation of pulmonary nodules AbstractSolitary pulmonary nodules (SPN) are a frequent problem in the clinical routine of pneumologists. In the evaluation of SPN, malignant nodules need to be differentiated from benign SPN with a high level of confidence. The management of SPN is based on the pre-test probability of malignancy (smoking history, other known malignancy) and on morphologic criteria seen on radiographs and especially CT. The presence of benign calcifications and a SPN that is stable on imaging tests for at least 2 years are highly suggestive of a benign lesion. For the indeterminate SPN ≤ 8 mm CT followup is recommended, with intervals depending on the size and pre-test-probability of malignancy. For the indeterminate SPN >8 mm, management should again be based on the pre-test probability of malignancy, with CT follow-up, dynamic CT and MRT, FDG-PET, histological analysis and possibly surgical removal representing the diagnostic options.

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“…Infirmities such as primary and metastatic neoplasm, inflammatory and infectious processes, circulatory disorders and degenerative conditions have their definitive diagnosis through histological examination (Chojniak et al 2011). In order to perform the biopsy, video-assisted thoracoscopy is recommended because it causes less trauma to the patient when compared to thoracotomy (Saviano & Tazzioli 1998) Thoracoscopic, pleuroscopic or video-assisted thoracoscopic surgery (VATS), when compared to thoracotomy, is a safe technique with minimal thoracic wall trauma, causing less pain, reduction of pneumothorax and subcutaneous emphysema, providing rapid recovery of the patient (Solli & Spaggiari 2007).…”

Section: Introductionmentioning

confidence: 99%

Lung biopsy with guillotine cutting needle and biopsy forceps though transdiaphragmatic thoracoscopy in dogs with pulmonary alterations

et al. 2018

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Lung diseases are common in small animal clinical routine. Diagnosis is usually affected due to nonspecific symptoms. Imaging features such as radiography and chest ultrasound are acceptable screening tests, although lung biopsy can provides a precise diagnosis. Thus thoracoscopy provides a minimally invasive diagnostic assessment for chest diseases and offers the benefits such as improved illumination and magnification of the image when compared with thoracotomy. In this study we evaluated the transdiaphragmatic thoracoscopic-assisted techniques of lung biopsy with a the guillotine cutting needle and biopsy forceps, in dogs presenting radiographic suspicion on pulmonary tumors. Fourteen dogs regardless of breed, gender, age and body weight admitted at the Hospital of Veterinary Clinics (HCV) of the Veterinary College (FAVET) of Universidade Federal do Rio Grande do Sul (UFRGS), were assessed. Inclusion criteria were presence of nodules on chest radiography and triage tests without changes that could hinder general anesthesia and surgical approach. The animals were positioned in dorsal recumbence and two thoracoscopic ports were established: the first port for working instruments; the second paraxyphoid port for the telescope. Three samples were collected using each sampling method from each lesion or from tumors macroscopically similar whenever their size was less than one centimeter. The samples were sent for histopathological examination in the Veterinary Pathology Laboratory of FAVET/UFRGS. Surgical time was recorded from first incision to wound closure and surgical complications were reported. The dogs were evaluated for the presence of subcutaneous emphysema, hematoma, seroma, local infection and dehiscence. No conversion to open surgery was necessary during the thoracoscopic procedure in any patient. Thoracoscopic assisted biopsy using guillotine needle and biopsy forceps was a safe and fast technique, without perioperative complications. Both devices provided good quality samples for histopathological analysis of lung abnormalities. However the cutting guillotine needle was more efficient especially in larger pulmonary nodules. The transdiaphragmatic access provided optimal approach for both hemithoraces.

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Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Cited by 15 publications

References 85 publications

Video-Assisted Surgery for Lung Cancer. State of the Art and Personal Experience

Video-Assisted Surgery for Lung Cancer. State of the Art and Personal Experience

Radiologische Abklärung pulmonaler Rundherde

Lung biopsy with guillotine cutting needle and biopsy forceps though transdiaphragmatic thoracoscopy in dogs with pulmonary alterations

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