Computed Tomography-guided Localization with a Hook-wire Followed by Video-assistedThoracic Surgery for Small Intrapulmonary and Ground Glass Opacity Lesions / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 624-629, 2009.
Article
in Korean
| WPRIM
| ID: wpr-54989
ABSTRACT
BACKGROUND:
Making the histologic diagnosis of small pulmonary nodules and ground glass opacity (GGO) lesions is difficult. CT-guided percutaneous needle biopsies often fail to provide enough specimen for making the diagnosis. Video-assisted thoracoscopic surgery (VATS) can be inefficient for treating non-palpable lesions. Preoperative localization of small intrapulmonary lesions provides a more obvious target to facilitate performing intraoperative resection. We evaluated the efficacy of CT-guided localization with using a hook wire and this was followed by VATS for making the histologic diagnosis of small intrapulmonary nodules and GGO lesions. MATERIAL ANDMETHOD:
Eighteen patients (13 males) were included in this study from August 2005 to March 2008. 18 intrapulmonary lesions underwent preoperative localization by using a CT-guided a hook wire system prior to performing VATS resection for intrapulmonary lesions and GGO lesions. The clinical data such as the accuracy of localization, the rate of conversion-to-thoracotomy, the operation time, the postoperative complications and the histology of the pulmonary lesion were retrospectively collected.RESULT:
Eighteen VATS resections were performed in 18 patients. Preoperative CT-guided localization with a hook-wire was successful in all the patients. Dislodgement of a hook wire was observed in one case. There was no conversion to thoracotomy. The median diameter of lesions was 8 mm (range 3~15 mm). The median depth of the lesions from the pleural surfaces was 5.5 mm (range 1~30 mm). The median interval between preoperative CT-guided localization with a hook-wire and VATS was 34.5 min (range 10~ 226 min). The median operative time was 43.5 min (range 26~83 min). In two patients, clinically insignificant pneumothorax developed after CT-guided localization with a hook-wire and there were no other complications. Histological examinations confirmed 8 primary lung cancers, 3 cases of metastases, 3 cases of inflammation, 2 intrapulmonary lymph nodes and 2 other benign lesions.CONCLUSION:
CT-guided localization with a hook-wire followed by VATS for treating small intrapulmonary nodules and GGO lesions provided a low conversion thoracotomy rate, a short operation time and few localization-related or postoperative complications. This procedure was efficient to confirm intrapulmonary lesions and GGO lesions.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumothorax
/
Postoperative Complications
/
Biopsy, Needle
/
Thoracotomy
/
Retrospective Studies
/
Thoracic Surgery, Video-Assisted
/
Operative Time
/
Glass
/
Inflammation
/
Lung Neoplasms
Type of study:
Observational study
Limits:
Humans
Language:
Korean
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2009
Type:
Article
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