Asuka Uebayashi1, Ryo Fujikawa2, Yoshifumi Arai3, Toru Nakamura4, Kazuhito Funai5. 1. Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka 430-8558, Japan. Electronic address: asukaue@yahoo.co.jp. 2. Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka 430-8558, Japan. Electronic address: reekun715@gmail.com. 3. Department of Pathology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka 430-8558, Japan. Electronic address: shee_0329@yahoo.co.jp. 4. Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka 430-8558, Japan. Electronic address: tonakamu@nifty.ne.jp. 5. First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka 431-3192, Japan. Electronic address: kfunai@hama-med.ac.jp.
Abstract
INTRODUCTION AND IMPORTANCE: Preoperative localization of non-palpable lung nodules plays an important role in video assisted thoracic surgery (VATS). Although percutaneous computed tomography (CT)-guided hook wire marking has become widely accepted, it is accompanied by rare but fatal complications such as air embolisms. We herein report a case of a submillimeter pulmonary nodule successfully localized by a mobile CT scan with a navigation system. CASE PRESENTATION: A 40-year-old-man presented with the two right pulmonary nodules 4 years after a radical left nephrectomy for a renal clear cell carcinoma. One of the nodules was too small to palpate and preoperative marking was applied using a mobile CT scan with a navigation system. We successfully performed VATS wedge resection for both nodules and confirmed a pathological diagnosis of a metastasis from the renal cell carcinoma. The maximum pathological size of the smaller nodule was 500 μm. CLINICAL DISCUSSION: Preoperative marking of the lower lobe lesion in the present case was essential for VATS. Our novel technique was helpful for the precise marking without any morbidity. CONCLUSION: Preoperative marking using a mobile CT scan with a navigation system is safe and easily applicable. It might be a useful option for VATS of non-palpable lung nodules.
INTRODUCTION AND IMPORTANCE: Preoperative localization of non-palpable lung nodules plays an important role in video assisted thoracic surgery (VATS). Although percutaneous computed tomography (CT)-guided hook wire marking has become widely accepted, it is accompanied by rare but fatal complications such as air embolisms. We herein report a case of a submillimeter pulmonary nodule successfully localized by a mobile CT scan with a navigation system. CASE PRESENTATION: A 40-year-old-man presented with the two right pulmonary nodules 4 years after a radical left nephrectomy for a renal clear cell carcinoma. One of the nodules was too small to palpate and preoperative marking was applied using a mobile CT scan with a navigation system. We successfully performed VATS wedge resection for both nodules and confirmed a pathological diagnosis of a metastasis from the renal cell carcinoma. The maximum pathological size of the smaller nodule was 500 μm. CLINICAL DISCUSSION: Preoperative marking of the lower lobe lesion in the present case was essential for VATS. Our novel technique was helpful for the precise marking without any morbidity. CONCLUSION: Preoperative marking using a mobile CT scan with a navigation system is safe and easily applicable. It might be a useful option for VATS of non-palpable lung nodules.
Keywords:
Case report; Image-guided video assisted thoracic surgery (iVATS); Mobile computed tomography; Navigation system; Non-palpable lung nodule; Preoperative marking
Authors: Thomas A Horan; Petrúcia M Pinheiro; Luis M Araújo; Flávia F Santiago; Monica R Rodrigues Journal: Ann Thorac Surg Date: 2002-05 Impact factor: 4.330
Authors: Sudish C Murthy; Kwhanmien Kim; Thomas W Rice; Jeevanantham Rajeswaran; Ronald Bukowski; Malcolm M DeCamp; Eugene H Blackstone Journal: Ann Thorac Surg Date: 2005-03 Impact factor: 4.330