Thoracoscopic localization techniques for patients with solitary pulmonary nodule: radioguided surgery versus hookwire localization.
OBJECTIVE
The aim of this study is to compare 2 different methods for localization of peripheral pulmonary lesions requiring thoracoscopic resection: radioguided surgery (still considered an innovative method) and computed tomography-guided hookwire localization.


METHODS
Thirty randomized patients (21 males and 9 females), ranging from 21-74 years, average age 56.3 years) with solitary pulmonary nodule (SPN) were enrolled in this prospective study. Inclusion criteria was: a maximum nodule diameter of less than 3 cm and a maximum distance from the visceral pleura of 3 cm. The patients were subdivided into 2 equal groups and one of the 2 different methods for diagnosing SPN was applied. Group A received a thoracoscopy using the scinti-probe technique and group B received a thoracoscopy aided by a hooked needle.


RESULTS
The frozen section revealed a primitive pulmonary tumor in 13 cases, intestinal adenocarcinoma metastasis in 3 cases and renal cancer metastasis in 1 case. The remaining 13 cases were pathologically benign: sarcoidosis in 6 cases, hamartochondroma in 3 cases, scleroanthracosis in 2 cases and tuberculoma in 2 cases.


CONCLUSIONS
On the basis of our experience, the conclusion is drawn that this methods has been proven efficacious in the diagnosis of SPN, and video-assisted thoracoscopy allows for the removal of pulmonary nodules without complications.
Davini
F
F
Thoracic Surgery Unit, Careggi Hospital, Florence, Italy. federicodavini@alice.it
Gonfiotti
A
A
Vaggelli
L
L
De Francisci
A
A
Gigli
P
P
Janni
A
A
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome