How big is the lung nodule that needs surgery?

There are usually three surgical indications for pulmonary nodules, one is regular follow-up, the other is non-surgical biopsy, and the third is surgery.

The indication of surgery is usually to consider the size of pulmonary nodules first. If it is less than 8 mm, only pathological stratification is needed. If it is greater than 8 mm, the specific method will be determined according to the cancer risk, surgical risk and patient preference. If the lung function and tolerance are poor, lobectomy can be considered.

Secondly, in the process of follow-up, if morphological and new changes are found, surgery should be considered at this time. There is also a special type, that is, ground glass, ground glass-like nodules with a diameter less than 50%, which are more likely to become cancerous or precancerous, so surgery should be considered. During the follow-up, the most common pulmonary nodules are the largest.

In addition to size, shape and follow-up, there are three classic surgical methods, one is thoracotomy, the other is mediastinoscopy and the other is thoracoscopy. Thoracoscopic surgery is more recommended and preferred for pulmonary nodules. The principle of thoracoscopic surgery is based on intraoperative pathology. If the pathological diagnosis during operation is benign, metastatic tumor, atypical hyperplasia, carcinoma in situ or micro-infiltration, in this case, lobectomy can be considered, and lymph node dissection is not emphasized. If it is invasive adenocarcinoma during operation, lobectomy and selective or systematic lymph node dissection should be considered.