Videothorascopic evaluation of the undeterminate pulmonary nodule: analysis of 47 operated cases

Between June 1992 and July 1993, 47 patients (13 female, 34 male) with diagnosis of Indeterminate Pulmonary Nodule (IPN) were operated on by VATS (Video-Assisted Thoracic Surgery). In all cases, the histopathologic diagnosis was obtained. In 19 patients we found solitary benign nodules, in 20 solitary malignant nodules, and in 8 multiple malignant nodules. An utility minithoracotomy (conversion) was necessary in 3/19 (15.7 percent) of the benign nodules due to difficulties in its localization, and in all (n=20) the malignant nodules in order to accomplish a complete resection, and in none of the multiple nodules (n=8). Six patients presented minor complications (morbidity = 10.6 percent) and one postoperative death was registered (mortality = 2.1 percent). We concluded that resection of the IPN by VATS is an oligotraumatic diagnostic procedure with a sensitivity and specificity of 100 percent, and with low mordibity and acceptable mortality, however it requires careful indication in patients with a high operative risk.