[Thoracoscopic wedge resection of small pulmonary nodules--evaluation of Endofinger and colored collagen injection techniques for localization of pulmonary nodules].
We analyzed problems occurring during thoracoscopic resection of small pulmonary nodules less than 2.0 cm in size and evaluated the Endofinger and colored collagen injection techniques, which are new methods for localization of pulmonary nodules. The Endofinger is a device for thoracoscopic palpation and the colored collagen is a long-lasting point marker, composed of 1.0% athelocollagen, methylene blue and contrast medium. Twenty five consecutive patients (male: female = 13:12, mean age 59.0 years) underwent thoracoscopic wedge excision of pulmonary nodules. The mean diameter of the nodules was 1.3 cm (range: 0.4-2.0 cm) and the mean distance from the pleural surface to the nodules, as assessed by CT scan, was 1.1 cm (range: 0-3.8 cm). Methods of pulmonary nodule identification were thoracoscopic inspection only (4 cases), palpation through min-thoracotomy (13 cases), Endofinger (2 cases) and Endofinger with colored collagen injection guided by CT scan (6 cases). In all cases where location was difficult to identify, the nodule diameter was less than 1 cm and the distance from the pleural surface to the nodule was greater than 1 cm. The Endofinger and colored collagen injection techniques have made it easier to localize small pulmonary nodules, decreasing the frequency of cases where additional thoracotomy is necessary. Seven of 25 nodules were revealed to be so-called early peripheral lung cancers, but no relapses were found in any of these cases following pulmonary resection. The new Endofinger and colored collagen injection techniques are useful in the localization of small pulmonary nodules, making thoracoscopic wedge resection of help in early diagnosis and treatment of pulmonary malignancy.
Horio
H
H
Department of Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Nomori
H
H
D001706:Biopsy; D003094:Collagen; D005260:Female; D006652:Histological Techniques; D006801:Humans; D008171:Lung Diseases / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010173:Palpation / Q000379:methods; D013906:Thoracoscopy
D003094:Collagen