Ara S Klijian1. 1. Departments of Thoracic Surgery, Sharp/Scripps Hospitals, San Diego, California, USA.
Abstract
BACKGROUND: Screening for lung cancer using high resolution computed tomography (CT) has produced encouraging early results. Extremely small nodules and non-palpable areas of opacifications are able to be detected, but pose a challenge to the thoracic surgeon trying to resect these areas. METHODS: Forty five patients with ground glass opacifications (GGOs) or small pulmonary nodules underwent pre-operative CT-guided placement of methylene blue dyed agar and/or hook wire needle localization prior to thoracoscopic resection. Progel was applied to any intraoperative air leaks observed after successful resection. RESULTS: All lesions were successfully excised thoracoscopically. The blue agar aided in localization of these areas and did not affect the histological architecture during pathologic evaluation. CONCLUSIONS: Careful pre-operative evaluation and planning, including use of selective CT-guided blue agar localization and hook wire placement, may greatly assist in thoracoscopically locating and resecting these often difficult-to-visualize lesions.
BACKGROUND: Screening for lung cancer using high resolution computed tomography (CT) has produced encouraging early results. Extremely small nodules and non-palpable areas of opacifications are able to be detected, but pose a challenge to the thoracic surgeon trying to resect these areas. METHODS: Forty five patients with ground glass opacifications (GGOs) or small pulmonary nodules underwent pre-operative CT-guided placement of methylene blue dyed agar and/or hook wire needle localization prior to thoracoscopic resection. Progel was applied to any intraoperative air leaks observed after successful resection. RESULTS: All lesions were successfully excised thoracoscopically. The blue agar aided in localization of these areas and did not affect the histological architecture during pathologic evaluation. CONCLUSIONS: Careful pre-operative evaluation and planning, including use of selective CT-guided blue agar localization and hook wire placement, may greatly assist in thoracoscopically locating and resecting these often difficult-to-visualize lesions.
Entities:
Keywords:
Needle localization; agar; guided lung biopsy; methylene blue
Authors: C I Henschke; D I McCauley; D F Yankelevitz; D P Naidich; G McGuinness; O S Miettinen; D M Libby; M W Pasmantier; J Koizumi; N K Altorki; J P Smith Journal: Lancet Date: 1999-07-10 Impact factor: 79.321