Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Video-Assisted Thoracic Surgery Core Needle Biopsy for Pulmonary Nodules in Patients with Impaired Lung Function: Is It Feasible and Safe?

  • Yong-Seong Lee (Department of Cardiothoracic Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • Jong Duk Kim (Department of Cardiothoracic Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • Hyun-Oh Park (Department of Cardiothoracic Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • Chung-Eun Lee (Department of Cardiothoracic Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • In-Seok Jang (Department of Cardiothoracic Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • Jun-Young Choi (Department of Cardiothoracic Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine)
  • Received : 2022.07.14
  • Accepted : 2022.10.18
  • Published : 2023.01.05
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Abstract

Background: The number of patients with incidentally identified pulmonary nodules is increasing. This study attempted to confirm the usefulness and safety of video-assisted thoracic surgery (VATS) core needle biopsy of pulmonary nodules. Methods: Data from 18 patients diagnosed with pulmonary nodules who underwent VATS core need biopsy were retrospectively reviewed. Results: Of the 18 patients, 15 had malignancies (primary lung cancer, n=14; metastatic lung cancer, n=1), and 3 had benign nodules. Mortality and pleural metastasis did not occur during the follow-up period. Conclusion: In patients with solitary pulmonary nodules that require tissue confirmation, computed tomography-guided percutaneous cutting needle biopsy or diagnostic pulmonary resection sometimes may not be feasible choices due to the location of the solitary pulmonary nodule or the patient's impaired pulmonary function, VATS core needle biopsy may be performed in these patients as an alternative method.

Keywords

References

  1. Yang W, Jiang H, Khan AN, et al. Transthoracic needle aspiration in solitary pulmonary nodule. Transl Lung Cancer Res 2017;6:76-85. https://doi.org/10.21037/tlcr.2017.02.03
  2. Nasim F, Ost DE. Management of the solitary pulmonary nodule. Curr Opin Pulm Med 2019;25:344-53. https://doi.org/10.1097/MCP.0000000000000586
  3. Cruickshank A, Stieler G, Ameer F. Evaluation of the solitary pulmonary nodule. Intern Med J 2019;49:306-15. https://doi.org/10.1111/imj.14219
  4. Choo JY, Park CM, Lee NK, Lee SM, Lee HJ, Goo JM. Percutaneous transthoracic needle biopsy of small (≤ 1 cm) lung nodules under C-arm cone-beam CT virtual navigation guidance. Eur Radiol 2013; 23:712-9. https://doi.org/10.1007/s00330-012-2644-6
  5. Verma A, Goh KS, Phua CK, et al. Diagnostic performance of convex probe EBUS-TBNA in patients with mediastinal and coexistent endobronchial or peripheral lesions. Medicine (Baltimore) 2016;95: e5619. https://doi.org/10.1097/MD.0000000000005619
  6. Deng CJ, Dai FQ, Qian K, et al. Clinical updates of approaches for biopsy of pulmonary lesions based on systematic review. BMC Pulm Med 2018;18:146. https://doi.org/10.1186/s12890-018-0713-6
  7. Odermatt M, Furrer M. Solitary pulmonary nodule on CT: observation or surgical resection? Ther Umsch 2012;69:394-400. https://doi.org/10.1024/0040-5930/a000305
  8. Kaaki S, Kidane B, Srinathan S, Tan L, Buduhan G. Is tissue still the issue?: lobectomy for suspicious lung nodules without confirmation of malignancy. J Surg Oncol 2018;117:977-84. https://doi.org/10.1002/jso.25003
  9. Ghamati MR, Li WW, van der Heijden EH, Verhagen AF, Damhuis RA. Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice? J Thorac Dis 2021;13: 5765-75. https://doi.org/10.21037/jtd-21-617
  10. McWilliams A, Tammemagi MC, Mayo JR, et al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med 2013;369:910-9. https://doi.org/10.1056/NEJMoa1214726
  11. Zhang R, Tian P, Chen B, Zhou Y, Li W. Predicting lung cancer risk of incidental solid and subsolid pulmonary nodules in different sizes. Cancer Manag Res 2020;12:8057-66. https://doi.org/10.2147/CMAR.S256719
  12. Siegelman SS, Khouri NF, Leo FP, Fishman EK, Braverman RM, Zerhouni EA. Solitary pulmonary nodules: CT assessment. Radiology 1986;160:307-12. https://doi.org/10.1148/radiology.160.2.3726105
  13. Khouri NF, Meziane MA, Zerhouni EA, Fishman EK, Siegelman SS. The solitary pulmonary nodule: assessment, diagnosis, and management. Chest 1987;91:128-33. https://doi.org/10.1378/chest.91.1.128
  14. Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis 2018;10:2331-7. https://doi.org/10.21037/jtd.2018.03.163
  15. Subotic D, Mandaric D, Radosavljevic G, Stojsic J, Gajic M. Lung function changes and complications after lobectomy for lung cancer in septuagenarians. Ann Thorac Med 2009;4:54-9. https://doi.org/10.4103/1817-1737.49413
  16. Volpino P, Cangemi R, Fiori E, et al. Risk of mortality from cardiovascular and respiratory causes in patients with chronic obstructive pulmonary disease submitted to follow-up after lung resection for non-small cell lung cancer. J Cardiovasc Surg (Torino) 2007;48:375-83.
  17. Kumar P, Goldstraw P, Yamada K, et al. Pulmonary fibrosis and lung cancer: risk and benefit analysis of pulmonary resection. J Thorac Cardiovasc Surg 2003;125:1321-7. https://doi.org/10.1016/s0022-5223(03)00028-x
  18. Motono N, Ishikawa M, Iwai S, Iijima Y, Usuda K, Uramoto H. Individualization of risk factors for postoperative complication after lung cancer surgery: a retrospective study. BMC Surg 2021;21:311. https://doi.org/10.1186/s12893-021-01305-0
  19. Zhou Y, Cui Z, Zhou X, et al. The presence of old pulmonary tuberculosis is an independent prognostic factor for squamous cell lung cancer survival. J Cardiothorac Surg 2013;8:123. https://doi.org/10.1186/1749-8090-8-123
  20. Liao H, Pu Q, Mei J, Ma L, Liu L. Value of video-assisted thoracic surgery core needle biopsy in the selection of surgical approaches for indeterminate pulmonary nodules. Ann Thorac Surg 2013;95:772. https://doi.org/10.1016/j.athoracsur.2012.07.073
  21. Matsuguma H, Nakahara R, Kondo T, Kamiyama Y, Mori K, Yokoi K. Risk of pleural recurrence after needle biopsy in patients with resected early stage lung cancer. Ann Thorac Surg 2005;80:2026-31. https://doi.org/10.1016/j.athoracsur.2005.06.074
  22. Inoue M, Honda O, Tomiyama N, et al. Risk of pleural recurrence after computed tomographic-guided percutaneous needle biopsy in stage I lung cancer patients. Ann Thorac Surg 2011;91:1066-71. https://doi.org/10.1016/j.athoracsur.2010.12.032
  23. Asakura K, Izumi Y, Yamauchi Y, et al. Incidence of pleural recurrence after computed tomography-guided needle biopsy in stage I lung cancer. PLoS One 2012;7:e42043. https://doi.org/10.1371/journal.pone.0042043
  24. Munoz-Largacha JA, Litle VR, Fernando HC. Navigation bronchoscopy for diagnosis and small nodule location. J Thorac Dis 2017;9(Suppl 2):S98-103. https://doi.org/10.21037/jtd.2017.01.57