Superselective Segmentectomy for Deep and Small Pulmonary Nodules Under the Guidance of Three-Dimensional Reconstructed Computed Tomographic Angiography

Nakamoto, Keiichi; Omori, Kazuhiko; Nezu, Kenji

doi:10.1016/j.athoracsur.2009.11.037

Cited by 46 publications

(37 citation statements)

References 31 publications

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“…After using the above method to determine the nodules location, identify a safe margin and plan a surgical approach, according to the anatomic character of pulmonary bronchus and arteries, the bronchus and arteries of the targeted segment are identified and made out on 3D images ( Figure 1B) (11,15,16). The segmental vein that runs on the surfaces of the intersegments and collects venous blood of the adjacent segments is the natural boundary of the segments, which should be preserved during operation.…”

Section: Identification Of the Targeted Segmental Anatomic Structuresmentioning

confidence: 99%

Three-dimensional computed tomography bronchography and angiography in the preoperative evaluation of thoracoscopic segmentectomy and subsegmentectomy

Wen

et al. 2016

J. Thorac. Dis.

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Section: Identification Of the Targeted Segmental Anatomic Structuresmentioning

confidence: 99%

Three-dimensional computed tomography bronchography and angiography in the preoperative evaluation of thoracoscopic segmentectomy and subsegmentectomy

Wen

et al. 2016

J. Thorac. Dis.

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“…The needle insertion angle and distance were accurately marked using three-dimensional coordinates, and the puncture points and needle insertion passage were defined using laser positioning lines and body surface signs. Increasing contact with the pulmonary tissue is a prerequisite in preventing dislocation of a metal hook (Nakamoto et al, 2010;Slotty and Stummer, 2012). In our study, the metal hook penetrated deep through the nodules into the pulmonary tissue below (1-2 cm), increasing the contact area of the metal hook.…”

Section: Discussionmentioning

confidence: 79%

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Zhai

Guan

et al. 2015

Genet. Mol. Res.

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ABSTRACT.This study aimed to analyze the clinical application value of computed tomography (CT)-guided hook-wire positioning before thoracoscopic surgery. Eighty-four patients who had received a thoracoscopic wedge resection of pulmonary nodules between January and December 2013 were selected. Group A consisted of 38 cases where the hook-wire positioning technique was not used, and the positioning approaches were intraoperative observation and palpation. Group B consisted of 46 cases where the hook-wire positioning technique was used. The diameter of each nodule was less than 2 cm, and all patients underwent the operation within 2 h of invasive positioning. The evaluation indexes included positioning success rate, positioningrelated complications, and rate of conversion to thoracotomy. In Group A, nine patients (23.68%) underwent conversion to thoracotomy; in Group B, three patients (6.52%) did. This difference was statistically significant (P < 0.05). The average operation duration was 118 ± 21 min in Group A and 53 ± 18 min in Group B. The difference between both groups was statistically significant (P < 0.05). The average length 3799 Positioning of pulmonary nodules ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 3798-3806 (2015) of hospital stay of patients who underwent conversion to thoracotomy was 8.7 ± 2.2 days, and of patients who underwent thoracoscopic pulmonary wedge resection was 4.5 ± 1.6 days. This difference was statistically significant (P < 0.05). Therefore, CT-guided hook-wire positioning of pulmonary nodules before thoracoscopic surgery has clinical application value. It helps to accurately locate the pulmonary nodules, effectively lowers the rate of conversion to thoracotomy, and reduces the operation duration.

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“…The procedure has some drawbacks: it is technically demanding, and it is difficult to comprehend the anatomical relations among the bronchus, pulmonary arteries and pulmonary veins. Preoperative three-dimensional contrast-enhanced computed tomography (3D-CT) simulation and the use of a vessel sealing system (VSS) to cut the vessels and dissect the parenchyma make this complicated surgery easier and more practical [4,5]. The case of a patient with VATS anterior basal segment of the right lower lobe (RS8) segmentectomy for stage IA NSCLC is presented.…”

Section: Introductionmentioning

confidence: 99%

Total thoracoscopic lung segmentectomy of anterior basal segment of the right lower lobe (RS8) for NSCLC stage IA (case report)

Miyajima

Watanabe

Uehara

et al. 2011

J Cardiothorac Surg

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A 69-year-old woman with a pulmonary nodule in anterior basal segment of the right lower lobe (RS8) was referred to our department. The diameter of the tumor was 12 mm, and it had increased over a few months. First, video-assisted thoracoscopic lung surgery (VATS) biopsy of the pulmonary nodule was carried out. Frozen section examination of this nodule confirmed the diagnosis of bronchioloalveolar carcinoma (BAC). Segmentectomy of RS8 with lower mediastinal node dissection (ND2a-1) was performed. The intersegmental plane was identified using the intersegmental veins as landmarks and the demarcation between the resected (inflated) and preserved (collapsed) lungs. Electrocautery at 70 watts was used to divide the intersegmental plane. A vessel sealing system was used to seal and cut the pulmonary arteries. Postoperative histopathological examination revealed that the tumor was T1aN0M0 BAC, and the minimal distance between the surgical margin and the tumor edge was 15 mm. The patient was discharged from hospital on postoperative day 5 without any complications.

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Superselective Segmentectomy for Deep and Small Pulmonary Nodules Under the Guidance of Three-Dimensional Reconstructed Computed Tomographic Angiography

Cited by 46 publications

References 31 publications

Three-dimensional computed tomography bronchography and angiography in the preoperative evaluation of thoracoscopic segmentectomy and subsegmentectomy

Three-dimensional computed tomography bronchography and angiography in the preoperative evaluation of thoracoscopic segmentectomy and subsegmentectomy

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Total thoracoscopic lung segmentectomy of anterior basal segment of the right lower lobe (RS8) for NSCLC stage IA (case report)

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