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Ann Thorac Surg 2003;75:1601-1605
© 2003 The Society of Thoracic Surgeons

Original article: general thoracic

Prospective study of thoracoscopic limited resection for ground-glass opacity selected by computed tomography

Masao Nakata, MDa*, Shigeki Sawada, MDa, Hideyuki Saeki, MDa, Shigemitsu Takashima, MDa, Hiroshi Mogami, MDb, Norihiro Teramoto, MDc, Kenji Eguchi, MDd

a Divisions of Surgery, Matsuyama, Japan
b Matsuyama, Japan
c Radiology, and Pathology, National Shikoku Cancer Center, Matsuyama, Japan
d Division of Pulmonary Medicine, Tokai University School of Medicine, Kanagawa, Japan

Accepted for publication November 11, 2002.

* Address reprint requests to Dr Nakata, Department of Surgery, National Shikoku Cancer Center, Horinouchi 13, Matsuyama, Ehime, 790-0007, Japan
e-mail: mnakata{at}shikoku-cc.go.jp

BACKGROUND: With recent advances in low-dose helical computed tomography (CT), detection of ground-glass opacity (GGO) has increased. The aim of this study was to correlate high-resolution CT (HRCT) findings with pathologic features and to evaluate the efficacy of thoracoscopic limited resection for focal GGO, which were selected based on HRCT findings.

METHODS: Focal GGO lesions were classified into two subtypes based on HRCT findings: pure type and mixed type. Ninety-six patients with persistent GGO 2 cm or less in diameter underwent pulmonary resection from January 1997 to December 2001. Among these, thoracoscopic wedge resection was performed prospectively between June 2000 and December 2001 in 33 patients with pure GGO lesions that were 1 cm or less.

RESULTS: Thoracoscopic wedge resection was completed with complete safety. The histologic diagnoses of these 33 lesions were adenocarcinoma in 1, bronchioloalveolar carcinoma (BAC) in 23, and atypical adenomatous hyperplasia (AAH) in 9. No patients have had any evidence of tumor recurrence to date. Of the total 96 GGO lesions, 93.0% (53/57) of pure GGO 1 cm or less were BAC or AAH, whereas 38.5% (15/39) of pure GGO larger than 1 cm or mixed GGO were adenocarcinoma.

CONCLUSIONS: Pure GGO 1 cm or less was characteristic of noninvasive lesions. Thoracoscopic limited resection for small GGO lesions selected by HRCT was valid.




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