Localización de nódulos pulmonares con arpón guiado por tomografía axial computarizada previa a la resección videotoracoscópica. Experiencia en 52 casos / Locating pulmonary nodules with a computed axial tomography-guided harpoon prior to videothoracoscopic resection. Experience with 52 cases

Introducción La resección videotoracoscópica (VTC) de los nódulos pulmonares (NP) periféricos requiere en ocasiones la práctica de una minitoracotomía para su localización mediante palpación. El objetivo de este estudio es evaluar la eficacia como método de localización preoperatoria de los NP de la colocación de un arpón guiado por TAC. Material y métodos Desde noviembre de 2004 hasta enero de 2011, 52 pacientes fueron programados para localización preoperatoria de 55 NP mediante la colocación de un arpón guiado por TAC. Resultados Un total de 52 pacientes (31 hombres y 21 mujeres) con edades entre 28 y 84 años (media: 62,2 años) con NP < 20mm (media: 9,57mm). De ellos, 35 tenían historia oncológica. Se colocaron 55 arpones (a 3 pacientes, 2 arpones simultáneos). En la VTC, 52 arpones fueron hallados correctamente anclados al NP. No se observaron complicaciones. En el grupo de 35 pacientes con antecedentes oncológicos, los nódulos resultaron ser malignos en 26 (74,3%). En los 17 no oncológicos fueron malignos el 70,6%. La estancia hospitalaria osciló entre 4 y 72 h, con 19 pacientes incluidos en un programa de cirugía ambulatoria (36,5%).Conclusiones La identificación preoperatoria de los NP permite su resección VTC directa. La colocación de un arpón guiado por TAC en los NP constituye un procedimiento seguro y efectivo que puede llevarse a cabo en un programa de cirugía ambulatoria (AU)

Objective Videothoracoscopic (VTC) resection of peripheral pulmonary nodules (PN) occasionally requires performing a mini-thoracotomy to locate them using palpation. The aim of this study is to evaluate the usefulness of inserting a CT-guided harpoon as a method for locating PN prior to surgery. Material and methods A study was conducted on a total of 52 patients who were scheduled for locating 55 PN prior to surgery by inserting a CT-guided harpoon, from November 2004 to January 2011.ResultsOf the 52 patients, of whom 35 had a history of cancer, 31 were male and 21 were female, with ages between 28 and 84 years (mean: 62.2 years) with a PN <20mm (mean: 9.57mm). A total of 55 harpoons were inserted (3 patients had 2 simultaneous harpoons). Using the VTC it was observed that 52 harpoons were correctly anchored to the PN. There were no complications. In the group of 35 patients with an oncology history, the nodules were malignant in 26 cases (74.3%), and there were 17 (70.6%) with malignant PN in those with no oncology history. The hospital stay varied between 4 and 72h, with 19 patients (36.5%) included in a one-day surgery program. Conclusions The preoperative identification of peripheral pulmonary nodules enables them to be removed directly with VTC. The insertion of a CT-guided harpoon in the PN is a safe and effective procedure that can be performed in a one-day surgery program (AU)

[Locating pulmonary nodules with a computed axial tomography-guided harpoon prior to videothoracoscopic resection. Experience with 52 cases]. / Localización de nódulos pulmonares con arpón guiado por tomografía axial computarizada previa a la resección videotoracoscópica. Experiencia en 52 casos.

OBJECTIVE: Videothoracoscopic (VTC) resection of peripheral pulmonary nodules (PN) occasionally requires performing a mini-thoracotomy to locate them using palpation. The aim of this study is to evaluate the usefulness of inserting a CT-guided harpoon as a method for locating PN prior to surgery. MATERIAL AND METHODS: A study was conducted on a total of 52 patients who were scheduled for locating 55 PN prior to surgery by inserting a CT-guided harpoon, from November 2004 to January 2011. RESULTS: Of the 52 patients, of whom 35 had a history of cancer, 31 were male and 21 were female, with ages between 28 and 84 years (mean: 62.2 years) with a PN <20mm (mean: 9.57mm). A total of 55 harpoons were inserted (3 patients had 2 simultaneous harpoons). Using the VTC it was observed that 52 harpoons were correctly anchored to the PN. There were no complications. In the group of 35 patients with an oncology history, the nodules were malignant in 26 cases (74.3%), and there were 17 (70.6%) with malignant PN in those with no oncology history. The hospital stay varied between 4 and 72h, with 19 patients (36.5%) included in a one-day surgery program. CONCLUSIONS: The preoperative identification of peripheral pulmonary nodules enables them to be removed directly with VTC. The insertion of a CT-guided harpoon in the PN is a safe and effective procedure that can be performed in a one-day surgery program.