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Localization of nonpalpable pulmonary nodules using CT-guided needle puncture.

Hsu HH, Shen CH, Tsai WC, Ko KH, Lee SC, Chang H, Huang TW - World J Surg Oncol (2015)

Bottom Line: We retrospectively reviewed the clinical data, technical details, surgical findings and pathologic results, and complications associated with CT-guided localization.Fifty-seven nodules (62.63%) were confirmed as malignances, including 45 primary lung cancer, and 34 nodules (37.37%) were confirmed as benign lesions.CT-guided needle puncture can be an effective and safe procedure prior to VATS, enabling accurate resection and diagnosis of small pulmonary nodules.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

ABSTRACT

Background: Surgical resection of small pulmonary nodule is challenging via thoracoscopic procedure. We describe our experience of computed tomography (CT)-guided needle puncture localization of indeterminate pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS).

Methods: From January 2011 to July 2014, 78 consecutive patients underwent CT-guided marking for the localization of 91 small pulmonary nodules. We retrospectively reviewed the clinical data, technical details, surgical findings and pathologic results, and complications associated with CT-guided localization.

Results: Seventy-eight consecutive patients (36 men and 42 women) underwent CT-guided marking localization of 91 indeterminate pulmonary nodules (62 pure ground-glass opacity nodules, 27 part-solid nodules, and 2 solid nodules). The mean size of the nodules was 8.6 mm (3.0-23.0 mm). The mean pleural distance between the nodule and lung surface was 11.5 mm (3.0-31.3 mm). The mean procedure time of CT-guided localization was 15.2 min (8-42 min). All patients stood the procedures well without requiring conversion to open thoracotomy. Twenty-four patients (30.77%) developed pneumothorax after the procedures. Only one patient required retention of the puncture needle introducer for air drainage. The mean visual assessment pain score was 1.7 (0-3). Fifty-seven nodules (62.63%) were confirmed as malignances, including 45 primary lung cancer, and 34 nodules (37.37%) were confirmed as benign lesions.

Conclusions: CT-guided needle puncture can be an effective and safe procedure prior to VATS, enabling accurate resection and diagnosis of small pulmonary nodules.

No MeSH data available.


Related in: MedlinePlus

This pulmonary hemorrhage was useful in identification of the target lesion
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Fig2: This pulmonary hemorrhage was useful in identification of the target lesion

Mentions: The location of nodule did not affect this procedure. The PD of the nodule did not affect the occurrence of pneumothorax. For deeper lesion, we often made more than one puncture for one lesion in the beginning of this study. However, there was no significant difference in the puncture number (one puncture hole group PD, 1.14 ± 0.69 mm; two puncture holes group PD, 1.15 ± 0.81, p = 0.99). The location of the nodules (central or peripheral lesion) had no significant influence on the attempt of puncture number (Table 6). For deeper nodules, it is possible to obtain two-dimensional localization when performing wedge resection of the lung parenchyma by using two punctures from different directions. This concept provides precise localization of nodules for VATS. In addition, pulmonary hemorrhage could result in pigmentation of the lung surface; this was useful in identification of the target lesion (Fig. 2). At initial practices, the patients were transferred to the operating room after localization procedures within half an hour. After that, we found that the puncture holes could still be identified even if the surgery was started 4 h later. With accumulation of more experiences, we propose that this procedure provides available time frame between labeling of nodule and surgery.Table 6


Localization of nonpalpable pulmonary nodules using CT-guided needle puncture.

Hsu HH, Shen CH, Tsai WC, Ko KH, Lee SC, Chang H, Huang TW - World J Surg Oncol (2015)

This pulmonary hemorrhage was useful in identification of the target lesion
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4536773&req=5

Fig2: This pulmonary hemorrhage was useful in identification of the target lesion
Mentions: The location of nodule did not affect this procedure. The PD of the nodule did not affect the occurrence of pneumothorax. For deeper lesion, we often made more than one puncture for one lesion in the beginning of this study. However, there was no significant difference in the puncture number (one puncture hole group PD, 1.14 ± 0.69 mm; two puncture holes group PD, 1.15 ± 0.81, p = 0.99). The location of the nodules (central or peripheral lesion) had no significant influence on the attempt of puncture number (Table 6). For deeper nodules, it is possible to obtain two-dimensional localization when performing wedge resection of the lung parenchyma by using two punctures from different directions. This concept provides precise localization of nodules for VATS. In addition, pulmonary hemorrhage could result in pigmentation of the lung surface; this was useful in identification of the target lesion (Fig. 2). At initial practices, the patients were transferred to the operating room after localization procedures within half an hour. After that, we found that the puncture holes could still be identified even if the surgery was started 4 h later. With accumulation of more experiences, we propose that this procedure provides available time frame between labeling of nodule and surgery.Table 6

Bottom Line: We retrospectively reviewed the clinical data, technical details, surgical findings and pathologic results, and complications associated with CT-guided localization.Fifty-seven nodules (62.63%) were confirmed as malignances, including 45 primary lung cancer, and 34 nodules (37.37%) were confirmed as benign lesions.CT-guided needle puncture can be an effective and safe procedure prior to VATS, enabling accurate resection and diagnosis of small pulmonary nodules.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

ABSTRACT

Background: Surgical resection of small pulmonary nodule is challenging via thoracoscopic procedure. We describe our experience of computed tomography (CT)-guided needle puncture localization of indeterminate pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS).

Methods: From January 2011 to July 2014, 78 consecutive patients underwent CT-guided marking for the localization of 91 small pulmonary nodules. We retrospectively reviewed the clinical data, technical details, surgical findings and pathologic results, and complications associated with CT-guided localization.

Results: Seventy-eight consecutive patients (36 men and 42 women) underwent CT-guided marking localization of 91 indeterminate pulmonary nodules (62 pure ground-glass opacity nodules, 27 part-solid nodules, and 2 solid nodules). The mean size of the nodules was 8.6 mm (3.0-23.0 mm). The mean pleural distance between the nodule and lung surface was 11.5 mm (3.0-31.3 mm). The mean procedure time of CT-guided localization was 15.2 min (8-42 min). All patients stood the procedures well without requiring conversion to open thoracotomy. Twenty-four patients (30.77%) developed pneumothorax after the procedures. Only one patient required retention of the puncture needle introducer for air drainage. The mean visual assessment pain score was 1.7 (0-3). Fifty-seven nodules (62.63%) were confirmed as malignances, including 45 primary lung cancer, and 34 nodules (37.37%) were confirmed as benign lesions.

Conclusions: CT-guided needle puncture can be an effective and safe procedure prior to VATS, enabling accurate resection and diagnosis of small pulmonary nodules.

No MeSH data available.


Related in: MedlinePlus