Fluoroscopy-guided barium marking for localizing small pulmonary lesions before video-assisted thoracic surgery

Iwasaki, Yoshinobu; Nagata, Kazuhiro; Yuba, Tatsuya; Hosogi, Shigekuni; Kohno, Kenji; Ohsugi, Shuji; Kuwahara, Hiroomi; Takemura, Yoshizumi; Yokomura, Ichiro

doi:10.1016/j.rmed.2004.07.015

Cited by 29 publications

(32 citation statements)

References 20 publications

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“…In decades, various techniques, including preoperative localization procedures, intraoperative localization using imaging modalities such as intraoperative ultrasonography, hook-wire, contrast media (5,6), dyes, microcoil, finger palpation, radio-guided, were used to overcome the aforementioned unfavorable factors, and the positive and negative aspects have been described (7). Along with the application of various localization methods and the accumulation of operating experience, numerous of doctors have been gradually recognized that physical methods such as hook wire localization showed excellent superiority (8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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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“…However, this technique is associated with the development of pneumothorax and wires maybe dislodged with movement [11]. The most commonly used dye, methylene blue may diffuse quickly to the uninvolved pleural surface and make localization difficult [12,13]. In our case, methylene blue marking was applied in the guideline of CT for the nodules.…”

Section: Discussionmentioning

confidence: 97%

“…Extrathoracic ultrasonography can be used successfully in the diagnosis of pleural conditions. It was used under local anesthesia and also in children with VATS [1,[6][7][8][9][10][11][12][13][14]. Ultrasonography was applied to 85 patients with different indications.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography for Localization of Subcentimetre Lung Nodules

Incekara¹,

Fındık²,

Smk³

et al. 2017

J Clin Respir Dis Care

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Localization of deeply, small, non-visible and non-palpable subcentimetre nodules can be difficult during videoassisted thoracoscopic surgery (VATS) and even during minithoracotomy. Linear ultrasound probe helps surgeon find these undetermined nodules by VATS or thoracotomy technique without any need of digital palpation and has been demonstrated a safe and feasible technique alternative to computed tomography guided procedure (coils, hook wires, methylene blue, lipidol and barium staining). Herein, we describe a case who we preoperatively labeled peripheral lung lesion in the right lower lobe with methylene blue digitalization were not possible by palpation and peripheral two lesions were successfully demonstrated with the use of linear ultrasound probe during thoracic surgery.

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“…[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. Second, unlike barium and colored dye, colorless lipiodol is favorable for pathological examination.…”

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-guided barium marking for localizing small pulmonary lesions before video-assisted thoracic surgery

Abstract: Fluoroscopy-guided barium marking is a safe, convenient, and reliable method for localization of small pulmonary lesions before VATS resection.

Cited by 29 publications

References 20 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

Ultrasonography for Localization of Subcentimetre Lung Nodules

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

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