CT-guided hook-wire localisation prior to video-assisted thoracoscopic surgery of pulmonary lesions.
Clin Radiol
; 72(10): 898.e7-898.e11, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28619443
ABSTRACT
AIM:
To assess the feasibility, safety, and efficacy of computed tomography (CT)-guided pulmonary nodule localisation using a hooked guide wire before video-assisted thoracoscopic surgery (VATS). MATERIALS ANDMETHODS:
The study included 79 patients with a history of malignancies outside the lung associated with pulmonary nodules. Mean lesion size was 0.7 cm (range 0.5-1.8 cm) and the mean lesion distance to the pleural surface was 1.5 cm (range 0.2-5 cm). All lesions (n=82) were marked with a 22-G hook wire. The technique was designed to insert the tip of the hook wire within or maximally 1 cm from the edge of the lesion. The Mann-Whitney U-test was used for univariate analyses and Fisher's exact test for categorical values.RESULTS:
The hooked guide wire was positioned successfully in all 82 pulmonary nodules within mean time of 9 minutes (8-20 minutes, SD 2.5 minutes). The procedure time was inversely proportional to the size of the lesion (Spearman correlation factor 0.7). Minimal pneumothoraces were observed in five patients (7.6%). Pneumothorax was not correlated to the histopathology of the pulmonary nodules (p>0.09). Focal perilesional pulmonary haemorrhage developed in four patients (5%). Both haemorrhage and pneumothorax were significantly correlated to lesions <10 mm (p=0.02 and 0.01 respectively). The volume of resected lung tissue was significantly correlated to lesions of increased distance from the pleural surface ≥2.5 cm in comparison to lesions of <2.5 cm from the pleural surface.CONCLUSION:
CT-guided pulmonary nodule localisation prior to VATS could enable safe, accurate surgical guidance for the localisation of small pulmonary nodules.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Cuidados Preoperatorios
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Tomografía Computarizada por Rayos X
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Radiografía Intervencional
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Cirugía Torácica Asistida por Video
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Nódulos Pulmonares Múltiples
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Neoplasias Pulmonares
Tipo de estudio:
Observational_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Radiol
Año:
2017
Tipo del documento:
Article