Why surgery is preferable in management of solitary pulmonary nodules?

ABSTRACT

This study included 108 patients who had solitary pulmonary nodules. 65 had malignant lesions [Group I] and 43 had nonmalignant nodules [Group II]. Bronchogenic carcinoma headed the list of malignant lesions [91%], while granulomas either specific or nonspecific headed the list of nonmalignant nodules [60%]. After thoracotomy, it was proved that the clinical, radiological, laboratory and bronchoscopic studies achieved the following In group I [GI] correct preoperative diagnosis in 3%, false negative diagnosis in 12% and the remaining 85% their lesions were suggestive of malignancy but without definite proof. In group II [GII] correct preoperative diagnosis was achieved in 20 nodules [granuloma [18], hamartoma [one] and pulmonary arteriovenous fistula [one]]. The preoperative diagnosis was different from post operative diagnosis in 6 cases. False diagnosis as bronchogenic carcinoma was reported in one case. The remaining lesions [16], their benign nature was established after thoracotomy. Surgery is the line of choice in dealing with such cases to explore, identify and resect the lesion whenever possible