Fluoroscopy-assisted thoracoscopic resection of pulmonary nodules after computed tomography–guided bronchoscopic metallic coil marking

Miyoshi, Takanori; Kondo, Kazuya; Takizawa, Hiromitsu; Kenzaki, Koichiro; Fujino, Haruhiko; Shoji, Shuichi; Tangoku, Akira

doi:10.1016/j.jtcvs.2005.09.019

Cited by 47 publications

(32 citation statements)

References 27 publications

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“…With our modified technique, this extra chest tube insertion would be unnecessary as no visceral pleural surface marker is used. Most techniques for microcoil insertion in the literature involve transthoracic percutaneous coil insertion, yet there are also reports of successful CT-guided bronchoscopic marking with metallic coils (19). This technique of pre-operative microcoil insertion followed by VATS resection has also been used successfully in the pediatric population for resection of small pulmonary nodules (20).…”

Section: Discussionmentioning

confidence: 99%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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Background: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface.Methods: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014.Results: A total of 63 patients were included (37% male, mean age 61.6±11.4 years). Forty-two patients (67%) had a history of smoking, with 10 current smokers. Sixty one (97%) patients underwent wedge resection and 3 (5%) patients had segmentectomy. Three (5%) patients required intra-operative staple line re-resection for positive or close margins. Eleven (17%) patients had a completion lobectomy, 5 of which were during the same anaesthetic. The average time between the CT-guided insertion and start of operation was 136.6±89.0 min, and average operative time was 84.0±53.3 min. The intra-operative complication rate was 5% (n=3), including 1 episode of hemoptysis, and 2 conversions to thoracotomy. The post-operative complication rate was 8% (5 patients), and included 2 air leaks, 1 hemothorax (drop in hemoglobin), 1 post chest tube removal pneumothorax, and one venous infarction of the lingula after lingula-sparing lobectomy requiring completion lobectomy. . Average post-operative length of stay was 2.2 days. A diagnosis was made for all patients.Conclusions: CT-guided microcoil insertion followed by VATS lobectomy is safe, with short operative times, short length of stay and 100% diagnosis of small pulmonary nodules. This technique will become more important in the future with increasing numbers of small nodules detected on CT as part of lung cancer screening programs.

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Section: Discussionmentioning

confidence: 99%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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“…There are several techniques to locate SPN, such as preoperative or intraoperative injection of methylene blue dye at the site of an SPN [14,15], intraoperative ultrasound, or radioguided detection and CT-guided positioning of a metal wire [16][17][18][19][20]. Each of these localization methods has its own advantages and drawbacks.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic solitary pulmonary nodule resection after CT-guided hookwire localization: 43 cases report and literature review

et al. 2010

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Background Peripheral subpleural solitary pulmonary nodules can be visualized and resected easily at thoracoscopy, but it is very difficult to localize deep nonpalpable pulmonary nodules that lie in lung parenchyma. The purpose of this article was to study the effectiveness of video-assisted thoracoscopic solitary pulmonary nodules resection after computed tomography (CT)-guided hookwire localization and to review the literature related to solitary pulmonary nodule diagnosis and treatment. Methods From April 2008 to June 2009, 43 patients with a solitary pulmonary nodule who had undergone CT-guided hookwire localization and video-assisted thoracoscopic surgery (VATS) were studied. Results Two cases were considered unsuccessful, other patients underwent CT-guided hookwire localization successfully, and ten patients had an asymptomatic minimal pneumothorax that did not require any intervention. The diameter of nodules ranged from 5 to 30 mm as measured by CT (mean 17.2 ± 7.5 mm). The distance between the center of nodule and visceral pleural ranged from 2 to 40 mm (mean 18.5 ± 9.3 mm). Of the 41 scheduled VATS procedures, 38 patients underwent thoracoscopic wedge resection. Twenty-two of 41 patients who revealed primary lung cancer after frozen-section examination underwent VATS lobectomy and lymphadenectomy. Three patients were converted to thoracotomy, and a major postoperative hemothorax occurred in one patient. No intra-or postoperative mortality or morbidity was recorded. Conclusions Video-assisted thoracoscopic solitary pulmonary nodule resection after CT-guided hookwire localization is a safe and effective procedure for accurate diagnosis and resection of indeterminate solitary pulmonary nodules.

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“…of VATS pulmonary resection, and our rate of 98.3% was comparable to that in previous reports. [2][3][4][5] Preoperative lipiodol marking of impalpable pulmonary nodules has several advantages over other marking methods such as metallic coil, [6][7][8][9] hook wire, [10][11][12][13][14] dye, [15][16][17] and barium. [18][19][20] First, it is possible to determine the proper central surgical cut lines because lipiodol can be injected adjacent to targeted lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative localization appears to resolve the former issue, and a number of small nodule localization techniques aimed at guiding VATS resection have been developed. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Although there are many techniques for preoperative localization of pulmonary lesions, CT-guided lipiodol marking may be the most appropriate method for impalpable pulmonary lesions for several reasons. We describe the procedure and assess the usefulness of the CT-guided lipiodol marking technique based on our experiences.…”

Section: Introductionmentioning

confidence: 99%

Video-Assisted Thoracoscopic Surgery after Preoperative CT-Guided Lipiodol Marking of Small or Impalpable Pulmonary Nodules

Mogi

Yajima

Tomizawa

et al. 2015

ATCS

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Purpose: Small pulmonary lesions that include ground-glass attenuation have been increasingly discovered because of progressive imaging diagnostic technologies. Despite the detection of such small lesions, sometimes it is quite difficult to localize them because of their size or considerable depth from the visceral pleura. In the present study, we examined the usefulness of computed tomography-guided lipiodol marking for thoracoscopic resection of impalpable pulmonary nodules. Methods: Fifty-six patients with an undiagnosed peripheral lesion(s) of the lung who had undergone preoperative computed tomography-guided lipiodol marking followed by video-assisted thoracoscopic surgery were studied. Results: All of the nodules were successfully marked by computed tomography-guided lipiodol marking, and all except for one case were localized by means of intraoperative fluoroscopy as clear spots. With regard to complications, pneumothorax occurred in 21 patients (37.5%), and only one patient required transient drainage. Although hemorrhaging in the lung parenchyma and hemosputum occurred in nine patients (16.1%) and one patient (1.8%), respectively, no patients were in serious condition. No intra-or postoperative mortality or morbidity was observed. Conclusion: Preoperative computed tomography-guided lipiodol marking of small or impalpable pulmonary nodules is a safe and useful procedure for thoracoscopic resection of the lung.

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Fluoroscopy-assisted thoracoscopic resection of pulmonary nodules after computed tomography–guided bronchoscopic metallic coil marking

Abstract: In this pilot study computed tomography-guided transbronchial metallic coil marking with an ultrathin bronchoscope with virtual bronchoscopic simulation might be a useful method for the fluoroscopy-assisted thoracoscopic resection of pulmonary nodules.

Cited by 47 publications

References 27 publications

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

Video-assisted thoracoscopic solitary pulmonary nodule resection after CT-guided hookwire localization: 43 cases report and literature review

Video-Assisted Thoracoscopic Surgery after Preoperative CT-Guided Lipiodol Marking of Small or Impalpable Pulmonary Nodules

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