ABSTRACT
OBJECTIVES: Videothoracoscopic visualization and/or palpation of pulmonary nodules may be difficult due to their location, small size or limited solid component. The purpose of this study is to present our experience with computed tomography (CT)-guided preoperative localization of pulmonary nodules by percutaneous marking with radio-labelled iodine-125 seeds. METHODS: A total of 34 pulmonary nodules were marked under CT with the placement of 33 radio-labelled iodine-125 seeds in 32 consecutive patients. RESULTS: All patients underwent biportal video-assisted thoracic surgery (VATS) and in no case was conversion to thoracotomy necessary. A total of 88.2% of the lung nodules were successfully resected. In the remaining 11.8%, migration of the seed to the pleural cavity occurred, although these nodules were still resected during VATS. Of all the patients with pneumothorax after the marking procedure, only one required chest tube placement (3.1%). No major postoperative complications were observed. CONCLUSIONS: Preoperative marking of pulmonary nodules with I-125 seeds under CT guidance is a feasible and safe technique that allows their intraoperative identification and resection.
Subject(s)
Lung Neoplasms , Multiple Pulmonary Nodules , Solitary Pulmonary Nodule , Humans , Iodine Radioisotopes , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Multiple Pulmonary Nodules/diagnostic imaging , Multiple Pulmonary Nodules/surgery , Preoperative Care , Retrospective Studies , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/surgery , Thoracic Surgery, Video-Assisted/methodsABSTRACT
Mediastinoscopy is considered a safe technique to biopsy mediastinal lesions. Among its complications, vascular ones are the most common. We present a rare case of intimal dissection of the innominate artery during the performance of a mediastinoscopy that caused an ischemic attack from which the patient recovered completely without long-term sequelae. We analyze the possible causes and risk factors of this complication.
Subject(s)
Brachiocephalic Trunk , Intraoperative Complications/etiology , Mediastinoscopy/adverse effects , Aged , Brachiocephalic Trunk/diagnostic imaging , Female , Humans , Intraoperative Complications/diagnostic imaging , Mediastinoscopy/methods , Tomography, X-Ray Computed , Video-Assisted SurgeryABSTRACT
Left cardiac sympathetic denervation is an effective therapy for patients with congenital long QT syndrome resistant to beta-blocker therapy. In this video tutorial we describe a minimally invasive video-assisted thoracoscopic technique for performing left cardiac sympathetic denervation.
