Abstract
The diagnostic value of flexible bronchoscopy (FB) in the preoperative work-up of solitary pulmonary nodules (SPN) is still under debate among pulmonologists, radiologists and thoracic surgeons.
In a prospective observational manner, FB was routinely performed in 225 patients with SPN of unknown origin.
Of the 225 patients 80.5% proved to have lung cancer and 7.6% a metastasis of an extrapulmonary primary, 12% had a benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 cases (or in 5.5% % of lung cancer cases). In addition, FB clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 of the lung cancer cases (46.5%). Surgery was cancelled due to the results of FB in four cases (one with involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy), one with SCLC, two with bacterial pneumonia), and the surgical strategy had to be modified to bilobectomy in one patient.
FB changed the planned surgical approach in five cases substantially. These results suggest that routine FB should be included in the regular preoperative work-up of patients with SPN.
- ERS