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A Simple and Safe Technique for CT Guided Lung Nodule Marking prior to Video Assisted Thoracoscopic Surgical Resection Revisited


Affiliations
1 Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom
2 Department of Thoracic Surgery, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom
 

Aim: We describe our experience of a simple, safe, and reproducible technique for lung nodule marking prethoracoscopic metastasectomy.Thoracoscopic lung nodule resection reduces patient discomfort, complications, higher level of care, hospital stay, and cost; however, small deeply placed lung nodules are difficult to locate and resect thoracoscopically. Materials and Methods: We describe and review the success of our novel technique, where nodules are identified on a low dose CT and marked with methylene blue using CT fluoroscopy guidance immediately prior to surgery. Results: 30 nodules were marked with a mean size of 8mm (4-18 mm) located at a mean depth of 17 mm, distributed through both lungs. Dye was detected at the pleural surface in 97% of the patients and at the nodule in 93%. There were no major complications.Thoracoscopic resection was possible in 90%. Conclusion: This is a simple and safe method of lung nodule marking to facilitate thoracoscopic resection in cases where this may not be technically possible due to nodule location.
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  • A Simple and Safe Technique for CT Guided Lung Nodule Marking prior to Video Assisted Thoracoscopic Surgical Resection Revisited

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Authors

James A. Stephenson
Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom
Ayman Mahfouz
Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom
Sridhar Rathinam
Department of Thoracic Surgery, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom
Apostolos Nakas
Department of Thoracic Surgery, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom
Amrita Bajaj
Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom

Abstract


Aim: We describe our experience of a simple, safe, and reproducible technique for lung nodule marking prethoracoscopic metastasectomy.Thoracoscopic lung nodule resection reduces patient discomfort, complications, higher level of care, hospital stay, and cost; however, small deeply placed lung nodules are difficult to locate and resect thoracoscopically. Materials and Methods: We describe and review the success of our novel technique, where nodules are identified on a low dose CT and marked with methylene blue using CT fluoroscopy guidance immediately prior to surgery. Results: 30 nodules were marked with a mean size of 8mm (4-18 mm) located at a mean depth of 17 mm, distributed through both lungs. Dye was detected at the pleural surface in 97% of the patients and at the nodule in 93%. There were no major complications.Thoracoscopic resection was possible in 90%. Conclusion: This is a simple and safe method of lung nodule marking to facilitate thoracoscopic resection in cases where this may not be technically possible due to nodule location.