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[CT-guided localization for thoracoscopic pulmonary wedge resection]

M Tajiri1, H Ishii, T Yamagata

  • 1First Department of Surgery, Kanagawa Cancer Center, Yokohama, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|January 1, 1997
PubMed
Summary

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Computed tomography (CT)-guided localization helps surgeons locate small peripheral lung lesions for thoracoscopic surgery. This technique improves diagnostic accuracy for difficult-to-find lung nodules, enhancing patient outcomes.

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.

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  • 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.