Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules.

Hongxu Yue,Zhimin Zhang,Yang Liu,Kaijie Fan

doi:10.1155/2021/1490709

Abstract

Purpose This is a retrospective research comparing the clinical outcomes of single-hole versus multi-hole video-assisted thoracoscopic surgical (VATS) resection for solitary pulmonary nodules (SPN) and examining the factors influencing the diagnosis of benign and malignant pulmonary nodules. Method We collected the clinical data, surgical status, outcomes, and corresponding imaging features of 317 patients with SPN who were surgically resected by VATS and diagnosed as benign or malignant by pathology in our hospital from January 2019 to December 2021. Result Among the 317 patients, 124 (39.12%) underwent single-port VATS and 193 (60.88%) underwent multiple-hole VATS. All patients were grouped according to the different surgical methods, and their postoperative indicators were statistically analyzed. The results showed that neither the single-port VATS group nor the multi-port VATS group had any serious adverse events such as death during the perioperative period. The average operation time, intraoperative blood loss, drainage tube indwelling time, and postoperative hospital stay were significantly lower in the two groups. Statistics of postoperative pathological diagnosis showed that 98 cases (30.91%) of all nodules were benign nodules and 219 cases (69.09%) were malignant nodules, and a further single-multivariate analysis showed that age, nodule maximum diameter, lobular sign, burr sign, vascular cluster sign, and pleural depression sign were independent relevant factors for the diagnosis of benign and malignant nodules. Conclusion VATS is less invasive and has fewer complications and is of great clinical value for both diagnosis and treatment of benign and malignant SPN. Age, maximum nodal diameter, lobar sign, burr sign, vascular set sign, and pleural depression sign were independent correlates affecting the diagnosis of benign and malignant SPN, which reminds that great attention should be paid to patients who are older and have risk factors on imaging, and early and timely active treatment or close follow-up should be carried out.

Highlights

Solitary pulmonary nodules (SPNs) are round or round-like lesions ≤30 mm in diameter within the lung parenchyma and are not associated with significant pulmonary atelectasis, satellite lesions, pleural effusion, or lymph node enlargement [1]. e detection rate of solitary pulmonary nodules (SPN) is showing an increasing trend with the improvement of people’s awareness of physical examination and the development of imaging technology. e emergence of SPN is often a sign of lung metastasis of early lung cancer or other malignant tumors and needs to be removed in time to avoid delaying the disease
Videoassisted thoracoscopic surgery (VATS) surgical approach is less traumatic, with fewer postoperative complications, avoiding additional nerve and tissue damage to the patient, and better postoperative rehabilitation, and diagnosis and treatment can be performed at the same time. e patient does not need to undergo a second operation, which reduces the burden on the patient to a greater extent and avoids repeated inspections and delays in treatment [6, 7]
Discussion e pathogenesis of SPN is complex, but its occurrence often suggests the presence of early lung cancer and other diseases [8]

Summary

Introduction

Solitary pulmonary nodules (SPNs) are round or round-like lesions ≤30 mm in diameter within the lung parenchyma and are not associated with significant pulmonary atelectasis, satellite lesions, pleural effusion, or lymph node enlargement [1]. e detection rate of SPN is showing an increasing trend with the improvement of people’s awareness of physical examination and the development of imaging technology. e emergence of SPN is often a sign of lung metastasis of early lung cancer or other malignant tumors and needs to be removed in time to avoid delaying the disease. It can be seen that early diagnosis of SPN and selection of the best treatment plan in the process of clinical practice are important ways to treat patients with lung tumors and reduce their mortality. E open-chest surgical exploration operation is a common and practical intraoperative diagnostic method, but this procedure can cause greater trauma to the patient’s body and is prone to various postoperative complications such as lung infection. Videoassisted thoracoscopic surgery (VATS) surgical approach is less traumatic, with fewer postoperative complications, avoiding additional nerve and tissue damage to the patient, and better postoperative rehabilitation, and diagnosis and treatment can be performed at the same time. E patient does not need to undergo a second operation, which reduces the burden on the patient to a greater extent and avoids repeated inspections and delays in treatment [6, 7].

Methods

Results

Conclusion