ObjectiveTo summarize the clinical experience of surgical resection of synchronous multiple ground-glass nodules (SMGN), and explore the individualized diagnosis and treatment strategy of SMGN.MethodsClinical data of 84 patients with SMGN who underwent thoracic surgery in Anhui Chest Hospital from July 2016 to August 2018 were analyzed retrospectively, including 18 males (21.4%) and 66 females (78.6%), aged 32-80 (55.6±10.3) years. The results of operation and the information of GGNs were analyzed.ResultsExcept for 1 patient who was converted to thoracotomy due to extensive dense adhesion of thoracic, other patients underwent video-assisted thoracoscopic surgery successfully. All patients recuperated successfully after operation, without severe perioperative complications or death. Finally, 79 patients were diagnosed as malignant tumors (94.0%), and 5 patients of benign lesions (6.0%). A total of 240 GGNs were removed, among which there were 168 pGGNs, including 68 benign lesions (40.5%) and 100 malignant tumors (59.5%), and 72 mGGNs, including 2 benign nodules (2.8%) and 70 malignant tumors (97.2%). Nodules diameter (P<0.001), consolidation/maximum diameter of nodule ratio (P<0.001), vacuole sign (P<0.001), air bronchograms sign (P=0.001), spine-like process (P=0.001), pleural indentation sign (P<0.001), lobulation sign (P<0.001), and vascular convergence (P=0.002) were correlated with malignant tumor.ConclusionAnalysis of the imaging features of GGNs by thin-section CT scan and three-dimensional reconstruction is of great value in predicting the benign and malignant nodules, which can guide the surgical decision-making and preoperative planning. Through reasonable preoperative planning and following certain principles, simultaneous surgical treatment for SMGN is safe and feasible.
ObjectiveTo summarize our experience of surgical resection of multiple ground-glass opacity (GGO) in recent years.MethodsClinical data of patients who underwent one-stage resections of multiple GGO from November 2015 to May 2019 in our hospital were collected, including 13 males and 52 females at an average age of 56.0±9.4 years. The clinical effects and pathological types of GGO were evaluated.ResultsTime interval from first discovery to surgery was 8-1 447 (236.5±362.4) days. There were 48 patients with unilateral surgery and 17 patients with bilateral surgery during the same period. Except for 2 patients who underwent open thoracotomy due to total thoracic adhesions, other patients underwent video-assisted thoracoscopic surgery (VATS). The mean postoperative hospital stay was 12.2±4.3 days. No severe perioperative complication or death occurred. A total of 156 GGO lesions were resected, 80 lesions were pure GGO, including 58 (72.5%) malignant lesions and 22 (27.5%) benign lesions, with an average diameter of 7.7±3.3 mm and 5.5±2.6 mm, respectively. Another 76 lesions were mixed GGO, including 69 (90.8%) malignant lesions and 7 (9.2%) benign lesions, with an average diameter of 13.6±6.6 mm and 7.7±3.5 mm, respectively.ConclusionPatients with multiple GGO should be treated with anti-inflammatory therapy firstly. When conservative treatment is ineffective and no benign outcomes are observed, surgical treatment should be considered. And when lung function is sufficient for patients to underwent surgeries, the simultaneous unilateral or bilateral thoracoscopic resection is suggested, and the sublobar resection or lobectomy methods can be adopted flexibly according to the clinical features of the lesion and the rapid pathological results, which will not increase the risk of postoperative complications. Otherwise, surgical resection should be given priority for pure GGO lesions with a diameter > 7.7 mm and mixed GGO lesions.
