Pulmonary nodule surgery: Difference between revisions

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Revision as of 15:41, 17 March 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Surgical excision is the mainstay therapy for malignant or high risk pulmonary nodules. In pulmonary nodule, surgical procedure selection will depend on the size, margins, and size of the tumor. The preferred surgical procedure is wedge resection by video-assisted thoracic surgery and pathological evaluation.^[1]

Surgery

Surgical excision is the mainstay therapy for malignant or high risk pulmonary nodules
Surgical excision is also the primary choice for the definitive diagnosis of malignant pulmonary nodules
In pulmonary nodule, surgical procedure selection will depend on the size, margins, and size of the tumor.
Common surgical procedures for the treatment of pulmonary nodule, include:

Wedge resection
Lobectomy
Segmentectomy
Lung volume reduction surgery
The preferred surgical procedure is wedge resection by video-assisted thoracic surgery and pathological evaluation.

The majority of surgical excisions include preoperative localization techniques, such as: preoperative placement of dye, technetium-99 radioguidance, ultrasound, or fluoroscopy.
In some cases, surgical excision may be preferred by patients with the following characteristics:^[1]

Non-compliant with follow-up
Desire for diagnostic certainty
Willingness to accept the risks associated with surgery

Complications

Common complications of solitary pulmonary nodule, include:^[1]

Nosocomial pneumonia

Prolonged mechanical ventilation
Respiratory failure
Bronchospasm
Pulmonary embolism

References

↑ ^1.0 ^1.1 ^1.2 Smetana GW, Lawrence VA, Cornell JE (2006). "Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians". Ann. Intern. Med. 144 (8): 581–95. PMID 16618956.

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[pmid16618956-1] 1.0 ^1.1 ^1.2 Smetana GW, Lawrence VA, Cornell JE (2006). "Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians". Ann. Intern. Med. 144 (8): 581–95. PMID 16618956.

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 *[[Bronchospasm]]
 *[[Pulmonary embolism]]
 ==References==