Preoperative and intraoperative ultrasonographic examination as an aid in lung cancer operations

Abstract

To assess the extent of tumor invasion in lung cancer, my colleagues and I routinely use preoperative transesophageal ultrasonic endoscopy and intraoperative ultrasonography in addition to preoperative roentgenography, computed tomographic scanning, and other standard procedures. Both transesophageal ultrasonic endoscopy and intraoperative ultrasonography allow for a real-time assessment of the extent to which the lung cancer has invaded adjacent organs and are useful in determining the operability and safety margin of the involved organ or organs. We found intraoperative ultrasonography to be more accurate than transesophageal ultrasonic endoscopy, because intraoperative ultrasonography can be done at any time during the operation, as needed, and the probe can be directly applied to the desired location from a variety of angles. In contrast, when transesophageal ultrasonic endoscopy is used, the presence of air in the lung tissue can interfere with an accurate evaluation of some aspects of the tumor. Our results indicate that the sensitivity of transesophageal ultrasonic endoscopy and intraoperative ultrasonography is 68.4% and 100%, respectively, and the specificity is 81.3% for transesophageal ultrasonic endoscopy and 95.5% for intraoperative ultrasonography.

Ultrasonographic evaluation of small nodules in the peripheral lung during video-assisted thoracic surgery (VATS)

“…Ultrasonography is widely used as a diagnostic tool in various clinical fields, such as percutaneous echoes [6], echoes during surgery [7 -11] and transbronchial echoes. However, only a few researchers have reported that ultrasonography can identify peripheral pulmonary nodules [9,10].…”

Intraoperative ultrasonographic localization of pulmonary ground-glass opacities

“…[2][3][4][5] Importantly, this tech-nique has now made it possible both to detect small nodules in the lung and to evaluate whether the lines of resection will achieve the required margins for solid lung nodules. 3,4,[6][7][8][9][10][11][12][13][14][15] Although the utility of IU for the management of GGO has remained unclear, we hypothesized that this procedure would enable the identification of small GGO lesions deep in the parenchyma and could serve as a guide in finding the appropriate margin in a deflated lung.…”

Intraoperative Thoracic Sonography

“…would be necessary. Therefore our investigations so far can not confirm the results and positive assessme nt made by Totsumum, who evaluated tum or invasion with a sensitivity of 97% (11). Given an increase in sound frequency for intraoperativelyapplicable probes such resu lts will of course be possible in the future.…”