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Preoperative localization of indeterminate pulmonary nodules before videothoracoscopic resection
M Paci1, V Annessi, F Giovanardi
1First Department of Surgery, Division of Thoracic Surgery, Santa Maria Nuova Hospital, viale Risorgimento 80, 42100 Reggio Emilia, Italy.
Background:
The management of a solitary pulmonary nodule is the subject of debate and minimally invasive diagnostic approaches have low sensitivity for small peripheral nodules. We discuss the role of video-assisted thoracoscopic surgery (VATS) in the management of solitary pulmonary nodules (SPNs) < or = 1 cm performed with a preoperative computed tomography-guided wire localization.
Methods:
Thirty-five selected patients underwent VATS resection for SPN, with localization by guide wire before surgery.
Results:
Seven patients, after VATS exploration, underwent thoracotomy because of pleuropulmonary adhesions, depth or dimensions. Histological diagnosis was obtained in all procedures; there was no postoperative morbidity or morbidity.
Conclusion:
Preoperative computed tomography hook-wire localization is a suitable strategy for peripheral nodules < or = 1 cm in diameter.