Yasuteru Shimamura1, Shigeru Sasaki2, Masashi Shimohira1, Hiroyuki Ogino3, Daisuke Yuki4, Katsumi Nakamae4, Masaki Hara2, Yuta Shibamoto1. 1. 1 Department of Radiology, Nagoya City University Graduate School of Medical Sciences , Nagoya , Japan. 2. 2 Department of Radiology, Nagoya City West Medical Center , Nagoya , Japan. 3. 3 Department of Proton Therapy, Nagoya City West Medical Center , Nagoya , Japan. 4. 4 Department of Thoracic Surgery, Nagoya City West Medical Center , Nagoya , Japan.
Abstract
OBJECTIVE: To retrospectively evaluate the feasibility of CT fluoroscopy-guided percutaneous marking using a 25-gauge needle and indigo carmine before video-assisted thoracoscopic surgery (VATS) for small lung lesions. METHODS: 21 patients, 14 males and 7 females, with a median age of 69 years (range, 40-79), underwent CT fluoroscopy-guided percutaneous VATS marking using a 25-gauge, 70-mm needle and 1.5-ml indigo carmine. The mean diameter of the lung lesions was 14 mm (range, 6-27). We evaluated the technical success rate, surgical success rate and complications related to this procedure by reviewing medical records and images. Technical success was defined as completion of this procedure. Surgical success was defined as resection of the target lesion with negative margins on pathological examination after VATS. Complications that required advanced levels of care were classified as major complications, and the remaining complications were considered minor. RESULTS: The technical success rate was 100%. In all cases, VATS was successfully performed as planned, and the target lesion was resected with negative margins on pathological examination after VATS. Thus, the surgical success rate was 100%. Mild pneumothorax was found in two cases, but further treatment was not required. The minor complication rate was 9.5% (2/21), and major complication rate was 0%. Only two patients (9.5%) complained of slight pain upon puncture, but local anaesthesia was not required. CONCLUSION: Percutaneous CT fluoroscopy-guided VATS marking using a 25-gauge needle without local anaesthesia appears feasible and safe. Advances in knowledge: This technique expands a possibility of the CT-guided marking.
OBJECTIVE: To retrospectively evaluate the feasibility of CT fluoroscopy-guided percutaneous marking using a 25-gauge needle and indigo carmine before video-assisted thoracoscopic surgery (VATS) for small lung lesions. METHODS: 21 patients, 14 males and 7 females, with a median age of 69 years (range, 40-79), underwent CT fluoroscopy-guided percutaneous VATS marking using a 25-gauge, 70-mm needle and 1.5-ml indigo carmine. The mean diameter of the lung lesions was 14 mm (range, 6-27). We evaluated the technical success rate, surgical success rate and complications related to this procedure by reviewing medical records and images. Technical success was defined as completion of this procedure. Surgical success was defined as resection of the target lesion with negative margins on pathological examination after VATS. Complications that required advanced levels of care were classified as major complications, and the remaining complications were considered minor. RESULTS: The technical success rate was 100%. In all cases, VATS was successfully performed as planned, and the target lesion was resected with negative margins on pathological examination after VATS. Thus, the surgical success rate was 100%. Mild pneumothorax was found in two cases, but further treatment was not required. The minor complication rate was 9.5% (2/21), and major complication rate was 0%. Only two patients (9.5%) complained of slight pain upon puncture, but local anaesthesia was not required. CONCLUSION: Percutaneous CT fluoroscopy-guided VATS marking using a 25-gauge needle without local anaesthesia appears feasible and safe. Advances in knowledge: This technique expands a possibility of the CT-guided marking.
Authors: Sébastien Bommart; Arnaud Bourdin; Grégory Marin; Jean Philippe Berthet; Jean Louis Pujol; Isabelle Serre; Nicolas Molinari; Charles Marty-Ané; Hélène Kovacsik Journal: Ann Thorac Surg Date: 2013-12-07 Impact factor: 4.330
Authors: Eric VanSonnenberg; Sridhar Shankar; Paul R Morrison; Rashmi T Nair; Stuart G Silverman; Michael T Jaklitsch; Franklin Liu; Lawrence Cheung; Kemal Tuncali; Arthur T Skarin; David J Sugarbaker Journal: AJR Am J Roentgenol Date: 2005-02 Impact factor: 3.959