[CT-guided localization for thoracoscopic pulmonary wedge resection]

Area of Science:

• Pulmonary Medicine
• Radiology
• Thoracic Surgery

Background:

• Advancements in roentgenology have increased the detection of small peripheral lung lesions.
• Diagnosing small lesions via transbronchial or percutaneous biopsy is challenging.
• Thoracoscopic surgery struggles with palpating deep or small lesions, and thoracotomy is overly invasive for diagnosis alone.

Purpose of the Study:

• To evaluate the efficacy of CT-guided localization for thoracoscopic pulmonary wedge resection of small peripheral lung lesions.
• To determine if CT-guided localization facilitates accurate surgical targeting of non-palpable lung nodules.

Main Methods:

• CT-guided localization was performed in 24 cases immediately prior to thoracoscopic surgery.
• Percutaneous puncture was used to place marking devices (Kopans spring hook wire or Naruke point marker) in or beside the lesions.
• Pathological analysis confirmed the nature and characteristics of the resected lesions.

Main Results:

• The study included 13 primary lung cancers, 4 focal fibroses, 2 metastases, and other benign lesions.
• Tumor diameters ranged from 3 to 33 mm (mean 9.0 mm).
• The distance from the visceral pleura to the tumor surface ranged from 0 to 24 mm (mean 10.9 mm). One case of pneumothorax occurred.

Conclusions:

• CT-guided localization is a valuable technique for identifying small peripheral lung lesions during thoracoscopic surgery.
• Prompt CT-guided localization before surgery can improve the reliability of identifying lesions.
• Minimizing complications like pneumothorax and marker dislodgement is crucial for successful implementation.