Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery
Background/Purpose: In video-assisted thoracic surgery (VATS) resection of small lung nodules, preoperative dye marking around the visceral pleura provides surface localization to help initiate resection, while implantation of a fiducial marker such as a microcoil can provide inner localization to a...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-06-01
|
| Series: | Journal of the Formosan Medical Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664618303607 |
| _version_ | 1818522210859483136 |
|---|---|
| author | Chi-Wei Lin Huan-Jang Ko Shun-Mao Yang Yi-Chang Chen Wei-Chun Ko Hsin-Chieh Huang Jin-Shing Chen Yeun-Chung Chang |
| author_facet | Chi-Wei Lin Huan-Jang Ko Shun-Mao Yang Yi-Chang Chen Wei-Chun Ko Hsin-Chieh Huang Jin-Shing Chen Yeun-Chung Chang |
| author_sort | Chi-Wei Lin |
| collection | DOAJ |
| description | Background/Purpose: In video-assisted thoracic surgery (VATS) resection of small lung nodules, preoperative dye marking around the visceral pleura provides surface localization to help initiate resection, while implantation of a fiducial marker such as a microcoil can provide inner localization to aid nodule resection under fluoroscopic guidance. We aimed to determine whether dual localization with microcoil placement and dye marking is safe and useful for guiding the resection of small deep-seated lung nodules. Methods: We retrospectively evaluated data pertaining to 39 consecutive patients (40 nodules) managed between January 2016 and December 2017 in our hospital. Dual localization with patent blue V dye and microcoil was performed preoperatively because the pulmonary nodules were expected to be difficult to visualize or palpate intraoperatively. The patients underwent computed tomography-guided dual localization in a single puncture and were then transferred to the operation room. Intraoperative fluoroscopy was used to ensure that the lung tissue resected included the microcoil. Results: All 40 lesions were successfully resected using the dual localization technique followed by fluoroscopy-assisted thoracoscopic surgery. The median lesion diameter and depth were 0.9 and 1.7 cm, respectively, while the median margin/diameter ratio in the first resected specimen was 1.25. One patient had failure of localization due to partial release of the microcoil into the chest wall. Localization-related pneumothorax was detected in six of 39 patients (15.4%) and was always self-limited. Conclusion: Dual localization with microcoil placement and dye marking is safe and supports successful VATS resection of small deep-seated lung nodules. Keywords: Dye, Localization, Microcoil, Pulmonary nodule |
| first_indexed | 2024-12-11T05:30:17Z |
| format | Article |
| id | doaj.art-3c436614631a4f5692ff9e64597323e3 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-11T05:30:17Z |
| publishDate | 2019-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-3c436614631a4f5692ff9e64597323e32022-12-22T01:19:26ZengElsevierJournal of the Formosan Medical Association0929-66462019-06-011186979985Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgeryChi-Wei Lin0Huan-Jang Ko1Shun-Mao Yang2Yi-Chang Chen3Wei-Chun Ko4Hsin-Chieh Huang5Jin-Shing Chen6Yeun-Chung Chang7Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, TaiwanDepartment of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, TaiwanDepartment of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, TaiwanInstitute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taiwan; Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan; Corresponding author.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, TaiwanBackground/Purpose: In video-assisted thoracic surgery (VATS) resection of small lung nodules, preoperative dye marking around the visceral pleura provides surface localization to help initiate resection, while implantation of a fiducial marker such as a microcoil can provide inner localization to aid nodule resection under fluoroscopic guidance. We aimed to determine whether dual localization with microcoil placement and dye marking is safe and useful for guiding the resection of small deep-seated lung nodules. Methods: We retrospectively evaluated data pertaining to 39 consecutive patients (40 nodules) managed between January 2016 and December 2017 in our hospital. Dual localization with patent blue V dye and microcoil was performed preoperatively because the pulmonary nodules were expected to be difficult to visualize or palpate intraoperatively. The patients underwent computed tomography-guided dual localization in a single puncture and were then transferred to the operation room. Intraoperative fluoroscopy was used to ensure that the lung tissue resected included the microcoil. Results: All 40 lesions were successfully resected using the dual localization technique followed by fluoroscopy-assisted thoracoscopic surgery. The median lesion diameter and depth were 0.9 and 1.7 cm, respectively, while the median margin/diameter ratio in the first resected specimen was 1.25. One patient had failure of localization due to partial release of the microcoil into the chest wall. Localization-related pneumothorax was detected in six of 39 patients (15.4%) and was always self-limited. Conclusion: Dual localization with microcoil placement and dye marking is safe and supports successful VATS resection of small deep-seated lung nodules. Keywords: Dye, Localization, Microcoil, Pulmonary nodulehttp://www.sciencedirect.com/science/article/pii/S0929664618303607 |
| spellingShingle | Chi-Wei Lin Huan-Jang Ko Shun-Mao Yang Yi-Chang Chen Wei-Chun Ko Hsin-Chieh Huang Jin-Shing Chen Yeun-Chung Chang Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery Journal of the Formosan Medical Association |
| title | Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery |
| title_full | Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery |
| title_fullStr | Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery |
| title_full_unstemmed | Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery |
| title_short | Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery |
| title_sort | computed tomography guided dual localization with microcoil and patent blue vital dye for deep seated pulmonary nodules in thoracoscopic surgery |
| url | http://www.sciencedirect.com/science/article/pii/S0929664618303607 |
| work_keys_str_mv | AT chiweilin computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT huanjangko computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT shunmaoyang computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT yichangchen computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT weichunko computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT hsinchiehhuang computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT jinshingchen computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery AT yeunchungchang computedtomographyguidedduallocalizationwithmicrocoilandpatentbluevitaldyefordeepseatedpulmonarynodulesinthoracoscopicsurgery |