Surgery

The SPN should be surgically removed in patients who have (1) a moderate-to-high risk for cancer and clinical signs that indicate that the nodule is malignant or (2) a nodule whose malignancy status cannot be determined even after a biopsy.

SPN is removed surgically by either thoracotomy (open lung surgery) or a video-assisted thoracoscopic surgery (VATS).

• Thoracotomy involves making a cut in the chest wall and removing small wedges of lung tissue. Patients undergoing this procedure are usually required to stay in the hospital for several days afterward. This procedure has a small risk for mortality.



• Video-assisted thoracoscopy is performed with the help of a thoracoscope (a flexible, lighted tube with a tiny camera at the end) inserted into the chest through a small cut on the chest wall. The camera displays the image on a TV screen, and the surgeon uses the display to guide the operation. Its advantages over thoracotomy include a shorter recovery time and a smaller incision.