Original article: general thoracicThoracoscopic resection of pulmonary nodules after computed tomographic–guided coil labeling
Section snippets
Material and methods
Since 1994 nearly 200 solitary small peripheral pulmonary nodules, inaccessible by bronchoscopy, have been diagnosed at our institution by TTNB. For 15 other lesions, TTNB was considered limited because of the size and the localization of these nodules (too small and deep) or contraindicated in cases of patients with severe respiratory disease. We decided to identify the nodules using thoracoscopic resection after microcoil marking. This group was composed of 14 patients, 7 men and 7 women,
Radiologic marking
Fifteen procedures have been performed by our team. During one of our first labeling procedures, the coil was not inserted deeply enough into the pulmonary parenchyma; although the chest radiograph that immediately followed showed the coil in place, at the time of perioperative localization, we found the coil at the bottom of the pleural cavity. We were able, however, to locate and resect the nodule after deflation of the lung.
In three cases (20%), a minor pneumothorax developed, but because
Comment
A solitary pulmonary nodule is defined as a noncalcified opacity measuring less than 3 cm in diameter, surrounded by normal pulmonary parenchyma, without accompanying adenopathy or atelectasia [1]. The diagnosis of solitary nodules remains a real challenge, and a precise histologic identification must be obtained when malignancy is suspected.
Bronchoscopy is a first-line diagnostic tool, yet it is not useful for nodules in peripheral parenchyma. For this kind of lesion, TTNB is necessary, and
Acknowledgements
The authors thank Miss Rosana Shaw for her kind collaboration.
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Methylene Blue/Collagen Mixture for CT-Guided Presurgical Lung Nodule Marking: High Efficacy and Safety
2020, Journal of Vascular and Interventional RadiologyCT Fluoroscopic-Guided Coil Localization of Lung Nodules prior to Video-Assisted Thoracoscopic Surgical Resection Reduces Complications Compared to Hook Wire Localization
2019, Journal of Vascular and Interventional RadiologyCitation Excerpt :Multiple techniques are available; the 2 most commonly described and studied are hook wire and coil localization (7). Coil localization, first described by Asamura et al (14) and later examined by Lizza et al (15), resulted in increased success rate for resection of lung nodules from 48% to 93%. Similarly, Wu et al (16) reported a shorter resection distance from the pleural surface to the lesion with coil localization prior to VATS.
Analysis of factors affecting successful microcoil localization for pulmonary nodules
2018, Journal of Surgical ResearchSupplement CT-Guided Microcoil Placement for Localising Ground-glass Opacity (GGO) Lesions at “Blind Areas” of the Conventional Hook-Wire Technique
2017, Heart Lung and CirculationCitation Excerpt :Richard J. Finley and colleagues also confirmed that preoperative CT-guided microcoil localisation decreased the need for thoracotomy or VATS anatomic resection [19]. As documented in the literature, the technique of coil localisation had a high success rate reaching even 97–100% [19–24] and low rate of complications [20]. Potential complications included pneumothorax, haemorrhage, haemoptysis and pulmonary embolism [19–24].