Reversible cardiac arrest related to late-onset coronary spasm after a positive ergonovine test.

scopic resection only should be considered for small (less than 3 cm) lesions in the outer third of the pulmonary parenchyma. However, as experience is gained with endo scopic surgical techniques and with the continued develop ment of improved instrumentation (such as endoscopic stapling devices), the indications for thoracoscopic pulmo nary resections are likely to increase. Currently, our approach to the evaluation ofthe peripheral pulmonary nodule consists of standard staging techniques that include computerized tomography and, when indicated, mediastinoscopy. When the diagnosis remains in question, our initial operative approach is thoracoscopic resection. The need for a more extensive resection can be determined based on the results of frozen-section pathologic analysis. Thoracotomy with its attendant morbidity can be avoided in patients with benign disease and in patients with meta static lesions. A select group of patients with bronchogenic carcinoma and severe impairment of lung function also may be best treated by thoracoscopic lung resection as definitive operative therapy. In summary, thoracoscopic resection of a benign lung nodule is described. Continued success with thoracoscopic resection is likely to have a significant impact on the operative management of select patients with pulmonary lesions. REFERENCES