Video-Assisted Thoracic Surgery Core Needle Biopsy for Pulmonary Nodules in Patients with Impaired Lung Function: Is It Feasible and Safe?

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: Large-core needle biopsy; Solitary pulmonary nodule; Video-assisted thoracic surgery.

Fig. 1

(A, B) Large solitary pulmonary nodule (4.5 cm) in a patient with impaired pulmonary function (predicted postoperative forced expiratory volume in 1 second: 42.5%). A, anterior; P, posterior; L, left; R, right.

Fig. 2

Flow chart for patient selection in this study. VATS, video-assisted thoracoscopic surgery; CT, computed tomography; PCNB, percutaneous cutting needle biopsy; EBUS-TNA, endobronchial ultrasound-guided transbronchial needle aspiration.

Fig. 3

Max-Core Disposable Core Biopsy Instrument (18G×20 cm; BD Corp., Franklin Lakes, NJ, USA).