Video-assisted thoracoscopic resection of pulmonary lesions

Aims. To determine the role of video-assisted thoracoscopic resection in the diagnosis of benign or malignant peripheral pulmonary lesions. Patients and method. In 157 patients, between 1996 and 2001, video-assisted thoracoscopy was used to remove a pulmonary lesion. Conversion rate, complications and histology are presented. Results. In 21 patients, conversion to a thoracotomy was necessary, four times because the pulmonary lesion was malignant and seventeen-times due to technical difficulties. In patients without any previous history of malignant disease (n = 100), 80% of the lesions were benign. In patients with malignant pulmonary Lesions (n = 21), curative resection was possible, 3 through VATS and 4 through thoracotomy. Pulmonary Lesions in patients with a previous history of malignant disease were malignant in 42 patients. Curative VATS resection of a solitary lesion was performed in 9 patients, in 10 patients thoracotomy was necessary to remove multiple lesions. Conclusions. With a pre-operative selection of the patients the rate of secondary thoracotomies due to bronchial carcinoma is low (4%). In patients with a previous history of malignant disease, 22% of the pulmonary lesions are benign. VATS is a safe diagnostic method, with Little discomfort for the patient. (C) 2004 Elsevier Ltd. All rights reserved.