Video-assisted thoracoscopic surgery for pulmonary nodules after computed tomography-guided marking with a spiral wire.
OBJECTIVE
Peripheral pulmonary nodules are preferably removed by minimally invasive techniques, such as video-assisted thoracoscopic (VATS) surgery. These nodules should be marked preoperatively for better intraoperative detection and removal.


METHODS
Twenty-two cases with a single pulmonary nodule requiring surgical removal for histologic examination were included in a prospective study. Guided by computed tomography, nodules were marked preoperatively using a laser marker system and fixed with a spiral wire. The marked nodules were removed by VATS surgery immediately after the marking.


RESULTS
The marking wire was placed in all 22 patients without any complications. The marked nodule was completely removed by VATS surgery in 19 patients. Conversion to thoracotomy was necessary in 3 patients, twice because of thoracoscopy-related problems and once because of a marking failure. The average times for the marking procedure and operation were 24 minutes and 32 minutes, respectively.


CONCLUSIONS
This new method of computed tomography-guided nodule marking with a spiral wire and subsequent VATS surgery is very efficient in terms of localization and stable fixation of subpleural pulmonary nodules.
Eichfeld
Uwe
U
Clinic for Abdominal, Transplant, Vascular and Thoracic Surgery, Leipzig University, Leipzig, Germany. eichu@medizin.uni-leipzig.de
Dietrich
Arne
A
Ott
Rudolph
R
Kloeppel
Rainer
R
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D005260:Female; D006222:Hamartoma / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007834:Lasers; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016726:Plasma Cell Granuloma, Pulmonary / Q000000981:diagnostic imaging / Q000601:surgery; D011300:Preoperative Care / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed