Aim:
to identify the efficient surgical tactics in case of
benign broncho-pulmonary tumors taking into account
co-morbidities and possibilities of video-assisted thora-
cic operations.
Materials and methods.
Among 133 pa-
tients with benign tumors of the lungs and bronchi 128
(96%) had tumors of peripheral localization, 5 (4%) —
of the central one. All patients with peripheral tumors
were operated on. Charlson index was used to assess the
co-morbidity.
Results.
In 120 (90.2%) patients tumors
were diagnosed during routine Х-ray examination or
casual check-up.6 (4.5%) patients showed clinical symp-
toms. The average terms of observation of patients with
peripheral tumors were 7.8 months (Me — 6, Q1 — 2,
Q3 — 7), with the central ones — 13.3 months (Me — 5, Q1 — 3, Q3 — 8). In 4 cases central tumors were removed
by endoscopy methods using electroresection and argon
plasma coagulation. In one case a stent was inserted.
More than 2/3 of patients had co-morbid pathologies.
Charlson index in co-morbid patients was 2.4±1.4, in
the group of patients elder than 70 years — 4.8±0.9. All
patients with peripheral tumors were operated on. The
video thoracoscopy approach was used in 56 (42.1%) pa-
tients, thoracotomy — in 67 (50.4%), video-assisted mi-
nithoracotomy — in 6 (4.5%). In 5.2% of cases thoracosco-
py was converted to thoracotomy. All peripheral tumors
were mesenchymal ones. Post-operative complications
developed in 7 (5.5%) patients. There were no mortality.
Conclusion.
Peripheral benign tumors of the lungs are
asymptomatic and require urgent surgery with an express
histology test to rule out lung cancer. Central tumors are
mostly removed by endoscopy. Video thoracoscopy is
the most efficient method to remove peri
pheral tumors.
Conversion to thoracotomy is usually necessary in case of
a small size and deep tumor localization.