Video-assisted thoracoscopic surgery for pulmonary nodules after computed tomography-guided marking with a spiral wire

Ann Thorac Surg. 2005 Jan;79(1):313-6; discussion 316-7. doi: 10.1016/j.athoracsur.2003.10.122.

Abstract

Purpose: Peripheral pulmonary nodules are preferably removed by minimally invasive techniques, such as video-assisted thoracoscopic (VATS) surgery. These nodules should be marked preoperatively for better intraoperative detection and removal.

Description: Twenty-two cases with a single pulmonary nodule requiring surgical removal for histologic examination were included in a prospective study. Guided by computed tomography, nodules were marked preoperatively using a laser marker system and fixed with a spiral wire. The marked nodules were removed by VATS surgery immediately after the marking.

Evaluation: The marking wire was placed in all 22 patients without any complications. The marked nodule was completely removed by VATS surgery in 19 patients. Conversion to thoracotomy was necessary in 3 patients, twice because of thoracoscopy-related problems and once because of a marking failure. The average times for the marking procedure and operation were 24 minutes and 32 minutes, respectively.

Conclusions: This new method of computed tomography-guided nodule marking with a spiral wire and subsequent VATS surgery is very efficient in terms of localization and stable fixation of subpleural pulmonary nodules.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma / diagnostic imaging
  • Carcinoma / secondary
  • Carcinoma / surgery
  • Female
  • Hamartoma / diagnostic imaging
  • Hamartoma / surgery
  • Humans
  • Lasers
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / surgery
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Plasma Cell Granuloma, Pulmonary / diagnostic imaging
  • Plasma Cell Granuloma, Pulmonary / surgery
  • Preoperative Care / instrumentation*
  • Preoperative Care / methods
  • Prospective Studies
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Solitary Pulmonary Nodule / surgery*
  • Thoracic Surgery, Video-Assisted*
  • Tomography, X-Ray Computed*