Fluoroscopy-guided barium marking for localizing small pulmonary lesions before video-assisted thoracic surgery.
OBJECTIVE
To evaluate the effectiveness of fluoroscopy-guided barium marking for localization of small peripheral pulmonary lesions before video-assisted thoracic surgery (VATS) resection.


METHODS
Twenty-one patients with peripheral pulmonary lesions 15 mm or less in diameter who were scheduled to undergo VATS resection were studied. A catheter was inserted bronchoscopically into the target segment and guided to a presumed lesion. The tip of the catheter was confirmed fluoroscopically to be at the exact spot determined beforehand. A 50% (weight/volume) barium sulfate suspension was instilled into the bronchus through the catheter, and the site of barium marking was ascertained by CT scanning.


RESULTS
The average instilled volume of barium was 0.42+/-0.07 ml. On CT scans, barium spots were superimposed on the target lesions in 19 of the 21 patients and were only 6-7 mm from the lesions in the other 2. Barium was well preserved in all patients at the time of VATS resection. A mild cough persisted for about 1 week in one patient, but the other patients had no specific complications.


CONCLUSIONS
Fluoroscopy-guided barium marking is a safe, convenient, and reliable method for localization of small pulmonary lesions before VATS resection.
Iwasaki
Yoshinobu
Y
Department of Medicine, Division of Pulmonary Medicine, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602, Japan. yiwasaki@koto.kpu-m.ac.jp
Nagata
Kazuhiro
K
Yuba
Tatsuya
T
Hosogi
Shigekuni
S
Kohno
Kenji
K
Ohsugi
Shuji
S
Kuwahara
Hiroomi
H
Takemura
Yoshizumi
Y
Yokomura
Ichiro
I
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D003287:Contrast Media; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D001466:Barium Sulfate