The application of image-guided video-assisted thoracoscopic surgery to bilateral pulmonary nodules resection

Abstract

Background: In tradition, bilateral small pulmonary nodules are localized in a computed tomography room and operation twice for fear of complications. In contrast, image-guided video-assisted thoracoscopic surgery (iVATS) is applied to localize small pulmonary nodules and resect these nodules in a single stage. The application of iVATS for bilateral pulmonary nodule localization and resection has not been explored. This study describes the methods and outcomes of bilateral small pulmonary nodule localization and resection in a single-staged method. Materials and Methods: This study is a retrospective analysis in our institute (Changhua Christian Hospital, Changhua, Taiwan). Patients with bilateral small pulmonary nodules who received single-staged iVATS from July 2018 to May 2020 were included in the study. The outcome measurements include operative time, localization time of one side, nodule pathologies, operative method, presence of complications, chest tube duration, and length of hospital stay (LOS). Results: Twenty-one patients with bilateral pulmonary nodules were included in this study, and a total of 50 pulmonary nodules were resected. The average operative time for a procedure was 203 min (95% confidence interval [CI]: 160–246 min), which included 18 min (95% CI: 13–23 min) of localization time for each side. Eight of 21 patients (38.10%) showed different pathologies among their bilateral nodules. There was only one complication noted; it was due to prolonged air leakage at the left side. Conclusion: There were about 40% different pathologies for synchronous bilateral lung nodules. Single-staged iVATS is feasible and efficient for bilateral small lung nodules resection.