[Analysis of surgical approach to diagnosis and therapy in solitary pulmonary nodules].

OBJECTIVE Descriptive-analytic appraisal of validity of surgical approach to diagnosis and therapy in solitary pulmonary nodules (SPNSs). TASK: to establish justification of surgical removing of SPNs which etiology is unclear after complete previous clinical investigation. PATIENTS AND METHODS In the period between 1 January 1999 and 1 January 2004, included in this investigation were all patients with SPN of unclear origin who were referred to the Clinic for Thoracic Surgery-UCC Sarajevo after complete previous clinical investigation. RESULTS We operated 60 patients with proved SPN. The malignancy was found in 44/60 (73,3%) patients. There were established following types of malignancy carcinoma planocellulare in 54,5%, adeno carcinoma in 36,5% carcinoma bronchioloalveolare in 4,5% and tumor carcinoides in 4, % patients. We did following types of operation atypical (wedge) resection in 20 (33,3%), lobectomy in 36 (60,0%) and pneumonectomy in 4 (6,7%) patients. There were neither intra- operative complications nor intra operative mortality. Postoperative morbidity include: pleural emphysema in 1 (1,65%) and stress ulcers in 1 (1,65%) patients. There was not early postoperative mortality (until 30 days after operation). CONCLUSION The malignancy was the most frequent cause of the SPNs. Operative and postoperative morbidity and mortality are relatively negligible. High percentage of the malignancy in SPNs, negligible operative and post operative morbidity and mortality justify aggressive surgical approach to diagnosis and therapy in SPNs and point out to the necessity for early removing of this kind of pulmonary lesion.