Annals of thoracic surgery short reports · 2023
Video-Assisted Thoracic Surgery Without Intraoperative Fluoroscopy After Microcoil Localization.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Lempel Jason K, Mercado Amiel, Murthy Sudish, Raymond Daniel P, Ahmad Usman, Bullen Jennifer, Bolen Michael A
Аннотация
BACKGROUND: Small nodules and ground-glass opacities can present a challenge when surgeons rely on direct visualization or digital palpation. Preoperative localization improves nodule detection. We aimed to determine the efficacy and safety of video-assisted thoracoscopic surgery (VATS) nodulectomy without intraoperative fluoroscopy after computed tomography (CT)-guided microcoil localization of peripheral pulmonary nodules.
METHODS: The cases of 147 consecutive patients (152 nodules) who underwent CT-guided microcoil localization (157 coils) followed by same-day VATS resection between 2016 and 2021 were retrospectively reviewed, and descriptive statistics were reported.
RESULTS: All 152 nodules (mean size, 13.5 ± 6.1 mm; mean distance to pleura, 4.2 ± 5.5 mm; 82 [54%] ground-glass nodules, 34 [22%] part-solid nodules) in study patients (mean age, 64.6 ± 11.8 years) were successfully resected. The technical success rate of percutaneous nodule localization with pleural tagging was 96% (150/157); the surgical efficacy of VATS nodulectomy without intraoperative fluoroscopy was 98% (149/152). Twelve patients (8%) required chest tubes after localization. Pathologic examination identified 24 benign and 123 malignant nodules, including 85 primary lung cancers.
CONCLUSIONS: CT-guided microcoil localization with pleural tagging is safe and effective and obviates the need for intraoperative fluoroscopy.
METHODS: The cases of 147 consecutive patients (152 nodules) who underwent CT-guided microcoil localization (157 coils) followed by same-day VATS resection between 2016 and 2021 were retrospectively reviewed, and descriptive statistics were reported.
RESULTS: All 152 nodules (mean size, 13.5 ± 6.1 mm; mean distance to pleura, 4.2 ± 5.5 mm; 82 [54%] ground-glass nodules, 34 [22%] part-solid nodules) in study patients (mean age, 64.6 ± 11.8 years) were successfully resected. The technical success rate of percutaneous nodule localization with pleural tagging was 96% (150/157); the surgical efficacy of VATS nodulectomy without intraoperative fluoroscopy was 98% (149/152). Twelve patients (8%) required chest tubes after localization. Pathologic examination identified 24 benign and 123 malignant nodules, including 85 primary lung cancers.
CONCLUSIONS: CT-guided microcoil localization with pleural tagging is safe and effective and obviates the need for intraoperative fluoroscopy.