What should I do if a lung nodule is found? With the popularity of medical checkups and advances in diagnostic equipment, it is not an isolated occurrence to find small unexplained nodules on lung imaging. Are these nodules benign or malignant? Patients are often uncertain as to whether they should continue to be observed or undergo immediate surgery. With these questions in mind, let’s hear what the experts have to say. What is a pulmonary nodule? Isolated pulmonary nodule refers to a single round or ovoid dense shadow in the lung parenchyma without hilar or mediastinal lymph node enlargement, pneumonia or pulmonary atelectasis, ≤2cm in diameter; further division of pulmonary nodule size: <4mm in diameter as micronodules (corn nodules); 4-10mm in diameter as small nodules (alveolar nodules); 10mm <20mm in diameter is collectively referred to as nodules. According to the density, they can be classified as ground glass density nodules, mixed ground glass density nodules, and solid nodules. How should nodules be treated?1. Follow-up observation: observation and follow-up is the least damaging method, which can avoid invasive operations such as biopsy or surgery, as well as the potential risks associated with them. Young, non-smoking or imaging data suggesting benign lesions can be considered for observation follow-up, and for patients who have contraindications to surgery, performing invasive operations would pose risks. Chest CT examinations are performed at intervals of 3, 6, 12, and 24 months from the initial examination, with a minimum observation period of 2 years. During the course of observation and follow-up, if the lesion changes, discontinuation of observation should be considered and surgical resection should be performed. Due to the possibility of malignancy and the consequent psychological burden, or in young women in the reproductive period, observation and follow-up is sometimes difficult to implement, can be considered thoracoscopic minimally invasive surgical treatment. 2, surgery: in the past, the surgical management of small isolated pulmonary nodules of unknown diagnosis is somewhat controversial, because about half of the small isolated pulmonary nodules are benign lesions, it is recommended that if the lesion occurs malignant manifestations during the observation process It is recommended that if malignant manifestations occur during observation, surgery should be performed again. Data show that the 5-year survival rate of early-stage lung cancer can be as high as 80% or more after surgery, and there is no need for radiotherapy and chemotherapy, and the quality of life is high. However, once mediastinal lymph node metastasis occurs, the 5-year survival rate is only about 20%. Early detection and timely treatment is the key to improve the prognosis of lung cancer. Therefore, most scholars now believe that small isolated lung nodules of indistinguishable nature should be treated by active surgery. Even benign nodules have the significance of resection, which can reduce the psychological burden of patients, reduce the radiation damage caused by repeated multiple CT examinations, and avoid the possibility of malignant transformation. As a minimally invasive procedure in thoracic surgery, thoracoscopic technique can make a definite diagnosis of pulmonary nodules and provide thorough treatment at the same time. The advantages of thoracoscopic surgery are less trauma, less pain, faster recovery and shorter hospital stay. 2 small incisions of 1-3 cm can remove the lesion and pathological examination can be made at that time. In the case of malignant lesions, lobectomy and lymph node dissection can be performed at the same time. In the case of benign lesions, only the mass is removed, which has no significant impact on lung function and the patient's postoperative quality of life, and relieves the patient of a heavy psychological burden. If the nodule is ≤4mm, please consult the Department of Thoracic Surgery, Department of Respiratory Medicine or Department of Oncology in 1 year to review the CT of the chest, and once the nodule is found to increase in diameter and density, immediate surgery is recommended. Nodules >4mm: If you find small nodules in the lung, nodules >4mm, please consult the Department of Thoracic Surgery, Department of Respiratory Medicine, Department of Oncology and review the CT of the chest within 1 month, once the nodules are found to increase in diameter and density, immediate surgery is recommended. Nodules ≥8mm: If you find small nodules in the lung with nodules ≥8mm on physical examination, please consult the thoracic surgery department within 1 month, and immediate thoracoscopic surgery is recommended. With high-definition thoracoscopic equipment and perfect minimally invasive surgical instruments, the Department of Thoracic Surgery of Xinhua Hospital Chongming Branch of Shanghai Jiaotong University School of Medicine has been the first to carry out thoracoscopic surgery in Chongming since 2010, especially since 2014, under the leadership of Director Wang Mingsong, the leader of the Department of Thoracic Surgery, widely carried out single-operation hole thoracoscopic surgery for pulmonary nodules, including lung wedge resection, lung segment resection, lung lobectomy and lymph node The surgery is less invasive and effective, providing first-class diagnostic and treatment solutions for patients with pulmonary nodules in Chongming, bringing a blessing to the people of the island.