Rika Yoshida1, Takeshi Yoshizako2, Shota Tanaka2, Shinji Ando2, Megumi Nakamura2, Koji Kishimoto3, Hajime Kitagaki2. 1. Department of Radiology, Shimane University, Faculty of Medicine, Japan. Electronic address: yoshidar@med.shimane-u.ac.jp. 2. Department of Radiology, Shimane University, Faculty of Medicine, Japan. 3. Department of Thoracic Surgery, Shimane University, Faculty of Medicine, Japan.
Abstract
OBJECTIVES: To investigate the utility and complications of computed tomography (CT)-guided color marking of impalpable pulmonary nodules for video-assisted thoracoscopic surgical resection. METHODS: This retrospective single institutional study has obtained Institutional Review Board approval. A total of 174 patients with 207 undiagnosed peripheral lesions of the lung were enrolled who had undergone preoperative computed tomography-guided color marking using colored collagen followed by video-assisted thoracoscopic surgery (VATS) from December 2015 to September 2018. RESULTS: All nodules (mean 14.0 mm, range 3.0-30.0 mm) were successfully marked by computed tomography-guided color marking, and 96.0% cases (167/174) were localized by means of intraoperative fluoroscopy as clear spots. Minor pneumothorax with a median volume of 3.8 mL (range 0.2-119.0 mL) occurred in 12 patients (6.9%) who were completely asymptomatic and were not in serious condition. No patient required a chest tube. No major bleeding complication occurred, and no air emboli were seen. No intra- or post-operative mortality of VATS was observed. CONCLUSIONS: Preoperative CT-guided color marking of impalpable pulmonary nodules is a safe and effective procedure that allows for successful surgical resection.
OBJECTIVES: To investigate the utility and complications of computed tomography (CT)-guided color marking of impalpable pulmonary nodules for video-assisted thoracoscopic surgical resection. METHODS: This retrospective single institutional study has obtained Institutional Review Board approval. A total of 174 patients with 207 undiagnosed peripheral lesions of the lung were enrolled who had undergone preoperative computed tomography-guided color marking using colored collagen followed by video-assisted thoracoscopic surgery (VATS) from December 2015 to September 2018. RESULTS: All nodules (mean 14.0 mm, range 3.0-30.0 mm) were successfully marked by computed tomography-guided color marking, and 96.0% cases (167/174) were localized by means of intraoperative fluoroscopy as clear spots. Minor pneumothorax with a median volume of 3.8 mL (range 0.2-119.0 mL) occurred in 12 patients (6.9%) who were completely asymptomatic and were not in serious condition. No patient required a chest tube. No major bleeding complication occurred, and no air emboli were seen. No intra- or post-operative mortality of VATS was observed. CONCLUSIONS: Preoperative CT-guided color marking of impalpable pulmonary nodules is a safe and effective procedure that allows for successful surgical resection.