Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue.

Lenglinger, F.; Schwarz, Christian; Artmann, W.

doi:10.2214/ajr.163.2.7518642

Cited by 183 publications

(135 citation statements)

References 10 publications

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“…Kastl (8) hold the point that hook wires are easily dislodged, resulting in high failure rates. Some researchers have reported that dislodgement rate in VATS resection with CT-guided single hook wire localization ranging from 0.4-4.9% (22,24,25). Compared to other reviews, the dislodgement rate in doublethorn hook wire applied by Chen (26) is up to 7%, whose incidence is within the 8-20% range reported in the literature (27,28).…”

Section: Discussionmentioning

confidence: 81%

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

et al. 2017

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Background: The aim of this study was to compare the effects of currently available preoperative localization methods, including semi-rigid single hook-wire, double-thorn hook-wire, and microcoil, in localizing the pulmonary nodules, thus to select the best technology to assist video-assisted thoracoscopic surgery (VATS) for small ground glass opacities (GGO).Methods: Preoperative CT-guided localizing techniques including semi-rigid single hook-wire, doublethorn hook-wire and microcoil were used in re-aerated fresh swine lung for location experiments. The advantages and drawbacks of the three positioning technologies were compared, and then the most optimal technique was used in patients with GGO. Technical success and post-operative complications were used as primary endpoints.Results: All three localizing techniques were successfully performed in the re-aerated fresh swine lung.The median tractive force of semi-rigid single hook wire, double-thorn hook wire and microcoil were 6.5, 4.85 and 0.2 N, which measured by a spring dynamometer. The wound sizes in the superficial pleura, caused by unplugging the needles, were 2 mm in double-thorn hook wire, 1 mm in semi-rigid single hook and 1 mm in microcoil, respectively. In patients with GGOs, the semi-rigid hook wires localizations were successfully performed, without any complication that need to be intervened. Dislodgement was reported in one patient before VATS. No major complications related to the preoperative hook wire localization and VATS were observed. Conclusions:We found from our localization experiments in the swine lung that, among the commonly used three localization methods, semi-rigid hook wire showed the best operability and practicability than doublethorn hook wire and microcoil. Preoperative localization of small pulmonary nodules with single semi-rigid hook wire system shows a high success rate, acceptable utility and especially low dislodgement in VATS. IntroductionThe widespread application of low-dose computed tomography (LDCT) has led to a great increase in the identification rate of small pulmonary nodules, especially small ground glass opacities (GGO). GGO is defined as a hazy opacity that does not obscure underlying bronchial structures or pulmonary vessels on CT scans (1). It has been reported that 33-60% GGO was malignant carcinoma when the nodules size ranges from 11-20 mm, while the malignant rate increase to 64-82% when the size grows up greater than 20 mm (2). Although the identification of pulmonary nodules could be effectively accomplished by many imaging modalities, including high-resolution CT, positron emission tomography (PET/CT), and bronchoscopy, whereas the identification of lesions with GGO remains difficult. Thus, more reliable diagnosis and therapeutic options for uncertain pulmonary nodules are still in need (3).Video-assisted thoracoscopic surgery (VATS) is less invasive in diagnosing and treating thoracic lesions, thus how to locate and mark the nodules more precisely before the VATS becomes one of the most important ...

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Section: Discussionmentioning

confidence: 81%

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

et al. 2017

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“…In one series, there was a delay up to one day after contrast injection until VATS resection, although this time lag did not affect the success of the procedure (47). The sole use of methylene blue, India ink, lipiodol and barium have also be reported in a few small series (48)(49)(50)(51)(52). Similar to the microcoil technique described above, most series involve the percutaneous placement of the contrast material yet some recent reports are using bronchoscopic guidance for pleural dye marking (53,54).…”

Section: Discussionmentioning

confidence: 99%

“…This technique has also been used in children, with one series reporting lung tattooing and VATS resection during the same general anaesthetic (55,56). The main cited limitation of this technique is that of diffusion of the contrast material and inability to accurately localize the pulmonary nodules, although in the studies mentioned above the technique was very successful with minimal complications (48,50). The use of surgical navigation systems with placement of skin fiducials to guide methylene blue injection has also been reported (57).…”

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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“…The procedure is performed through small incisions making it impossible to palpate the nodules manually [75]. Current tumour localization techniques include methylene blue staining and the insertion of a hook wire [76][77][78][79][80][81]. These methods have been found to be cumbersome, have a high failure rate, and increase medical risks and litigation [82][83][84].…”

Section: Lung Tumour Localizationmentioning

confidence: 99%

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

Yu¹,

Lewis²,

Trejos³

et al. 2011

CRMR

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New technological concepts have been evolving to manage the relative poor prognosis of lung cancer. Brachytherapy is becoming an option for both unresectable and early resectable lung cancer. Three-dimensional ultrasound (US) of lung tumours and image-guided minimally invasive robotics-assisted brachytherapy are feasible for dosimetry planning and management of lung tumours. The present article reviews the current knowledge of lung brachytherapy and discusses its potential in future management of lung cancer.

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Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue.

Cited by 183 publications

References 10 publications

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

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

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

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