Using a Dedicated Lung-Marker System for Localization of Pulmonary  Nodules Before Thoracoscopic Surgery

Partik, B.; Leung, Ann N.; Müller, Michael; Breitenseher, Martin; Eckersberger, F.; Dekan, Gerhard; Helbich, Thomas H.; Metz, V.

doi:10.2214/ajr.180.3.1800805

Cited by 47 publications

(26 citation statements)

References 22 publications

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“…Preoperative and intraoperative nodule localization techniques include computed tomography dye injection [15,16], intraoperative endoscopic ultrasonography [17] and preoperative computed tomography guided hookwire localization [18]. In our series, nodules as small as 4 mm in size were identified without the need of additional methods.…”

Section: Selected Controlled Ventilation Came With the Introduction Omentioning

confidence: 78%

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

Pompeo¹,

Mineo²,

Rogliani³

et al. 2004

The Annals of Thoracic Surgery

220

171

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Background. General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic pulmonary resection. We assessed in a randomized study the feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules.Methods. Between March 2001 and February 2003, 60 patients were randomized into two 30-patients arms: a general anesthesia arm entailing double-lumen intubation and thoracic epidural anesthesia (control group); and an awake arm entailing sole thoracic epidural anesthesia at T4-T5 (awake group). Anesthesia time; operative time; global operating room time; patient satisfaction with the anesthesia and technical feasibility scored into 4 grades (from 1 ‫؍‬ poor to 4 ‫؍‬ excellent); visual analog pain score (VAS), nursing care (number of patient calls per day), 24 hours changes in arterial oxygenation (⌬PaO 2 ), and hospital stay were assessed.Results. There was no mortality. There was no difference

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Section: Selected Controlled Ventilation Came With the Introduction Omentioning

confidence: 78%

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

Pompeo¹,

Mineo²,

Rogliani³

et al. 2004

The Annals of Thoracic Surgery

220

171

View full text Add to dashboard Cite

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“…Also, they reported that insertion of the hookwire does not negatively impact outcome for patients with malignancy, with no evidence of tumour seeding or dissemination secondary to hook insertion (27). The second commercially available hookwire system has a coiled tip to be placed within the lung parenchyma, with a flexible wire that is brought external and coiled on the chest wall prior to VATS (28). A number of groups have reported results using this system, with success rates ranging from 86-100% and dislodgement rates of 0-9% (28)(29)(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

“…The second commercially available hookwire system has a coiled tip to be placed within the lung parenchyma, with a flexible wire that is brought external and coiled on the chest wall prior to VATS (28). A number of groups have reported results using this system, with success rates ranging from 86-100% and dislodgement rates of 0-9% (28)(29)(30)(31)(32). Other hookwire designs have been attempted, with success rates for VATS resection ranging from 88-100% with few complications reported and low rates of dislodgement (33)(34)(35)(36)(37).…”

Section: Discussionmentioning

confidence: 99%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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Background: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface.Methods: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014.Results: A total of 63 patients were included (37% male, mean age 61.6±11.4 years). Forty-two patients (67%) had a history of smoking, with 10 current smokers. Sixty one (97%) patients underwent wedge resection and 3 (5%) patients had segmentectomy. Three (5%) patients required intra-operative staple line re-resection for positive or close margins. Eleven (17%) patients had a completion lobectomy, 5 of which were during the same anaesthetic. The average time between the CT-guided insertion and start of operation was 136.6±89.0 min, and average operative time was 84.0±53.3 min. The intra-operative complication rate was 5% (n=3), including 1 episode of hemoptysis, and 2 conversions to thoracotomy. The post-operative complication rate was 8% (5 patients), and included 2 air leaks, 1 hemothorax (drop in hemoglobin), 1 post chest tube removal pneumothorax, and one venous infarction of the lingula after lingula-sparing lobectomy requiring completion lobectomy. . Average post-operative length of stay was 2.2 days. A diagnosis was made for all patients.Conclusions: CT-guided microcoil insertion followed by VATS lobectomy is safe, with short operative times, short length of stay and 100% diagnosis of small pulmonary nodules. This technique will become more important in the future with increasing numbers of small nodules detected on CT as part of lung cancer screening programs.

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“…It was recommended to place the wire or coil right into the solid nodule or more than 2 cm deep into the lung tissue for more stable anchorage (21). However, our experience demonstrated that this kind of manipulation might be unsuitable for GGN lesion, as it may dramatically increase the chance of dislodgment due to the comparatively soft and loose composition of these lesions.…”

Section: Discussionmentioning

confidence: 96%

A novel hybrid technique for localization of subcentimeter lung nodules

Pang

Chen

et al. 2017

J. Thorac. Dis.

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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 CTguided 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.Keywords: Video-assisted thoracoscopic surgery; lung nodule; localization; computed tomography (CT); J Thorac Dis 2017;9(4):1107-1112 jtd.amegroups.com established, such as hook-wire or microcoil labelling, intraoperative ultrasound scan, methylene blue staining and radio-guided detection. Among them, CT-guided hookwire or microcoil techniques are preferable due to higher sensitivity, less operator dependence and lower complication rate (3-5). Nevertheless, dislodgment of the wire or coil after the lung collapses in the surgery remains a disturbing problem and leads to a relatively higher failure rate of marking (6). In the current study, we developed a novel hybrid technique, which combines induced controllable pneumothorax and CT-guided microcoil marking, to reduce or even eliminate the risk of dislodgment. MethodsBetween May 2015 and March 2016, 35 patients with 37 subcentimeter lung GGNs who underwent preoperative CT-guided microcoil marking and VATS resections at our institution were retrospectively reviewed. Only subpleural lesions, presumed impalpable, with a maximum distance to the pleural surface of 30mm were included. Lesions were incidentally found in 33 patients while they underwent health examination or were being examined for other medical reasons. In 2 patients with a clinical history of malignancy, the lesions were found during follow-up examination. No preoperative pathologic diagnoses were obtained, either by fiberoptic bronchoscopy (FOB) or by CT-guided needle lung biopsies. Preoperative marking procedureT ...

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Using a Dedicated Lung-Marker System for Localization of Pulmonary Nodules Before Thoracoscopic Surgery

Abstract: The dedicated lung-marker system is a fast and effective method for localization of pulmonary nodules before thoracoscopic resection.

Cited by 47 publications

References 22 publications

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

Feasibility and Results of Awake Thoracoscopic Resection of Solitary Pulmonary Nodules

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

A novel hybrid technique for localization of subcentimeter lung nodules

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