Journal of thoracic disease · 2017
A novel hybrid technique for localization of subcentimeter lung nodules.
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Pang Xuguang, Xue Liang, Chen Jiemin, Ding Jianyong
Аннотация
BACKGROUND: It is technically challenging to locate non-visible, non-palpable subcentimeter ground-glass nodules (GGNs) of lung during video-assisted thoracic surgery (VATS). Computed tomography (CT)-guided marking of small pulmonary nodules using microcoils has been reported to be a practical method of preoperative localization, whereas dislodgement of microcoils remains to be a bothersome complication. The objective of this study was to assess the viability and effectiveness of a newly developed hybrid technique, which combines induced controllable pneumothorax and CT-guided microcoil marking procedure to reduce the risk of microcoil dislodgement.
METHODS: After induced minor pneumothorax, 35 patients with subcentimeter GGNs underwent CT-guided marking with microcoils prior to VATS sublobar resection or lobectomy. Histopathological analysis was performed after surgeries.
RESULTS: All of 37 nodules were successfully marked before VATS. Segmentectomy was performed in 8 cases, wedge resection in 19 cases and lobectomy in 8 cases. All nodules were completely removed with marking microcoils. Dislodgement of microcoils was not observed in all cases and mild pulmonary hemorrhage occurred in one case. No other complications occurred.
CONCLUSIONS: The newly developed hybrid technique which combines induced controllable pneumothorax and CT-guided marking using microcoils was feasible and reliable for VATS resection of subcentimeter GGNs, meanwhile significantly lowered the risk of microcoil dislocation.
METHODS: After induced minor pneumothorax, 35 patients with subcentimeter GGNs underwent CT-guided marking with microcoils prior to VATS sublobar resection or lobectomy. Histopathological analysis was performed after surgeries.
RESULTS: All of 37 nodules were successfully marked before VATS. Segmentectomy was performed in 8 cases, wedge resection in 19 cases and lobectomy in 8 cases. All nodules were completely removed with marking microcoils. Dislodgement of microcoils was not observed in all cases and mild pulmonary hemorrhage occurred in one case. No other complications occurred.
CONCLUSIONS: The newly developed hybrid technique which combines induced controllable pneumothorax and CT-guided marking using microcoils was feasible and reliable for VATS resection of subcentimeter GGNs, meanwhile significantly lowered the risk of microcoil dislocation.