TANIMLANAMAYAN SOLİTER PULMONER NODÜLLERDE CERRAHİ TEDAVİ

Soliter pulmoner nodüllerin bir kısmını benign lezyonlar oluşturduğu için, tanı ve tedavide erken agresif girişimler tartışmalıdır. Biz, tanımlanamayan soliter pulmoner nodül sebebi ile torakotomi yaptığımız olgularda cerrahi morbidite ve mortaliteyi araştırdık. Anabilim Dalımızda tanımlanamayan soliter pulmoner nodül sebebiyle torakotomi uygulanmış 25 hasta gözden geçirildi. Olguların %40’ı malign, %60’ı benign natürde idi. Gereksiz torakotomi oranı %12 idi. Olguların ikisinde 2. ayda yapılan kontrolde insizyon yerinde ağrı tesbit edildi.(morbidite %8) Hastanede kalış süresi ortalama 4.2 gündü. Mortalite görülmedi. Soliter pulmoner nodüllerde malign olanların hemen hepsinin ve benign olanların önemli bir kısmının esasen cerrahi tedavi ihtiyacı gösterdiği bu olgularda cerrahi tedavinin minimal morbidite ve mortalite ile yapılabilecek güvenli bir tanı ve tedavi seçeneği olduğu düşünüldü

Anahtar Kelimeler:

Soliter pulmoner nodül, tanı, cerrahi

Surgical Treatment in Undeterminated Solitary Pulmonar Nodules

Because some of the solitary pulmonar nodules are benign, early aggressive approaches for diagnosis and treatment are controversial. We investigated the surgical morbidity and mortality in cases which we have performed thoracotomy for undeterminated solitary pulmonar nodules. We reviewed the 25 cases which we have performed thoracotomy for undeterminated solitary pulmonar nodules in our clinic. 40 % of cases were in malign and 60 % of cases were in bening nature. Unnecessary thoracotomy incidence was 12 %. We found incision pain in two patients during controls done 2 mounths after operation. The average hospitalization time was 4.2 days. There was no mortality. All of malign and most of benign solitary pulmonar nodules need surgical treatment. In these cases, surgical treatment is a safe method for diagnosis and treatment and can be performed with minimal morbidity and mortality

Keywords:

Solitary pulmonary nodul, diagnosis, surgery,

PDF

___

Davies B, Ghosh S, Hopkinson D, Vaughan R, Rocco G. Solitary pulmonary nodules: pathological outcome of 150 consecutively resected lesions. Interact Cardiovasc Thorac Surg. 2005,4:18-20.
Saito H, Minamiya Y, Kawai H, et al. Usefulness of circumference difference for estimating the likelihood of malignancy in small solitary pulmonary nodules on CT. Lung Cancer. 2007, 3: 123-5.
Diederich S, Das M. Solitary pulmonary nodule: detection and management. Cancer imaging 2006 , 31: 42-6.
Bergmann T, Bölükbas S, Beqiri S, Trainer S, Schirren J. Solitary pulmonary nodule : Assessment and therapy. Chirurg. 2007, 78:687-97. 5. Shields T W, Robinson P G.. Benign Tumors of The Lung. In: Shields TW,Locicero J, Ponn BR, Rusch WV.(eds).General Thoracic Surgery. Sixth edition. Lippincott Williams &Wilkins, Philedelphia 2005, pp 1778- 1800 .
Karasik A. Increased risk of lung cacer in patients with chondromatous hamartoma. J Thorac Cardiovasc 1980, 80:217.
Van Den Bosch JM. Mesenchymoma of the lung (So- called hamartoma):a rewiev of 154 paranchimal and endobronchial cases. Thorax 1987, 42:790.
Hirai S, Hamanaka Y, Mitsui N, Morifuji K, Uegami S. Role of video-assisted thoracic surgery for the diagnosis of indeterminate pulmonary nodule. Ann Thorac Cardiovasc Surg. 2006,12:388-92.
Davini F, Gonfiotti A, Vaggelli L, De Francisci A, Gigli P, Janni A. Thoracoscopic localization techniques for patients with solitary pulmonary nodule: radioguided surgery versus hookwire localization. J Cardiovasc Surg (Torino). 2006, 47:355-9.
Prosch H, Strasser G, Oschatz E, Schober E, Schneider B, Mostbeck GH. Management of patients with small pulmonary nodules: a survey of radiologists, pulmonologists, and thoracic surgeons.AJR Am J Roentgenol. 2006,187:143-8