末梢型肺腫瘤性病変に対する肺生検の検討 : 胸腔鏡手術および後側方開胸による

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Traditional diagnostic approaches include bronchoscopy and percutaneous needle biopsy. Albeit both methods are minimally invasive, the diagnosis of the small, peripheral nodule may remain elusive. We enforced video-assisted thoracoscopic lung biopsy (VATS-LB) or open lung biopsy (OLB) for 160 cases of the definitive diagnosis of the solitary pulmonary nodule. Eighty-one patients underwent VATS-LB and 79 patients underwent OLB. In both groups a definitive diagnosis was procured in 100% of cases. Malignancy was found in 91 cases (56.9%) in both groups. Primary lung cancer was found in 68 cases (74.7%) of malignant lesion included adenocarcinoma in 50 cases (73.5%). The mean diameter of the resected nodules in the VATS-LB group was 1.4 ± 0.7 cm compared with 2.3 ± 1.6 cm for the OLB group (p<0.01). The rate of malignancy in nodules measuring 10 mm or less was 46.9% in the VATS-LB group and 17.7% in the OLB group. The operating time was 123.2 ± 60.8 minutes in the VATS-LB group compared with 191.7 ± 90.7 minutes in the OLB group (p<0.01). Mean postoperative hospital stay was 8.8 ± 4.0 days in the VATS-LB group and 12.2 ± 5.6 days in the OLB group (p<0.01). This report demonstrated that VATS-LB for an indeterminate pulmonary nodule could be performed with little morbidity and no mortality in selected patients. We concluded that video-assisted thoracoscopic lung biopsy is more safely and effective procedure in selected patients with an indeterminate pulmonary nodule.
東京女子医科大学の論文
2000-05-25

末梢型肺腫瘤性病変に対する肺生検の検討 : 胸腔鏡手術および後側方開胸による

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