title: Successful thoracoscopic lung biopsy in children utilizing preoperative CT-guided localization.
abstract: OBJECTIVE
  Although thoracoscopy in children is a well-accepted technique, there are limitations to this approach. Small lung nodules or those not located on the pleural surface often require an open thoracotomy. The purpose of this report is to evaluate the utility of computed tomography (CT) guided needle localization of lung nodules in children followed by thoracoscopic resection.
  
  
  METHODS
  From 1997 to 2000, 13 thoracoscopic procedures were performed on 12 children who presented with small pulmonary nodules (<1 cm) or nodules deep to the pleural surface. Preoperative needle localization was performed by injecting methylene blue under CT guidance. Patients then were taken directly to the operating room for thoracoscopic resection.
  
  
  RESULTS
  All 13 procedures were completed successfully thoracoscopically. Twelve yielded diagnostic pathologic findings as well as therapeutic resections in 7. All patients underwent extubation in the operating room, and chest tubes were removed within 36 hours. No thoracotomies were performed, and there were no complications.
  
  
  CONCLUSIONS
  Preoperative localization utilizing CT guidance is safe and beneficial in children with pulmonary nodules less than 1 cm in size and those located deep to the pleural surface. This technique allows the surgeon to perform thoracoscopy for diagnosis and therapeutic resection of these lesions rather than submitting patients to the morbidity of a thoracotomy.
authors.affiliation: Department of Pediatric Surgery, The Children's Hospital, University of Colorado, Denver, CO 80218, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Partrick
authors.forename: Denis D
authors.initials: DD
authors.lastname: Bensard
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Teitelbaum
authors.forename: James D
authors.initials: JD
authors.lastname: Geiger
authors.forename: Peter
authors.initials: P
authors.lastname: Strouse
authors.forename: Roger K
authors.initials: RK
authors.lastname: Harned
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013906:Thoracoscopy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods