Computed tomography-guided microcoil placement for localizing small pulmonary nodules before uniportal video-assisted thoracoscopic resection
| Autor: | Enrico Paci, Marco Andolfi, Francesco Xiumé, Alberto Roncon, Michele Salati, Andrea Giovagnoni, Gian Marco Guiducci, Majed Refai, Francesca Barbisan, Michela Tiberi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Operative Time Microcoil Radiography Interventional 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Fiducial Markers medicine Humans Fluoroscopy Radiology Nuclear Medicine and imaging Thoracotomy Aged Retrospective Studies Aged 80 and over Hematoma Solitary pulmonary nodule medicine.diagnostic_test Thoracic Surgery Video-Assisted business.industry Pneumothorax Nodule (medicine) Interventional radiology General Medicine Middle Aged medicine.disease 030220 oncology & carcinogenesis Feasibility Studies Multiple Pulmonary Nodules Female Radiology medicine.symptom business Wedge resection (lung) |
| Zdroj: | La radiologia medica. 125:24-30 |
| ISSN: | 1826-6983 0033-8362 |
| DOI: | 10.1007/s11547-019-01077-x |
| Popis: | The increasing number of computed tomography (CT) performed allows the more frequent identification of small, solid pulmonary nodules or ground-glass opacities. Video-assisted thoracic surgery (VATS) represents the standard in most lung resections. However, since VATS limit is the digital palpation of the lung parenchyma, many techniques of nodule localization were developed. The aim of this study was to determine the feasibility and safety of CT-guided microcoil insertion followed by uniportal VATS wedge resection (WR). Retrospective study in a single institution, including patients undergone CT-guided microcoil insertion prior to uniportal VATS resection between May 2015 and December 2018. The lesion was identified using fluoroscopy. Forty-six consecutive patients were enrolled (22 male and 24 female). On CT: 5 cases of GGO, 2 cases of semisolid nodules, 39 cases of solid nodules. The median pathologic tumor size was 1.21 cm. Neither conversion to thoracotomy nor microcoil dislodgement was recorded. All patients underwent uniportal VATS WR (9/46 underwent completion lobectomy after frozen section). WR median time was 105 min (range 50–150 min). No patients required intraoperative re-resection for positive margins. After radiological procedure, 1 case of hematoma and 2 cases of pneumothorax were recorded. Four complications occurred in the postoperative period. The mean duration of chest drain and length of stay were 2.9 and 4.6 days, respectively. CT-guided microcoil insertion followed by uniportal VATS resection was a safe and feasible procedure having a minimal associated complications rate and offering surgeons the ease of localization of small intrapulmonary nodules. |
| Databáze: | OpenAIRE |
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