Percutaneous localization of pulmonary nodules prior to thoracoscopic surgery by CT-guided hook-wire.
BACKGROUND
When performing thoracoscopic surgery in patients with small pulmonary nodules, intraoperative localization can be difficult and time-consuming. The percutaneous localization of suspicious intrapulmonary lesions was evaluated pre-operatively to facilitate the resection of the lesion and to avoid thoracotomy.


METHODS
Thoracoscopies were performed in 13 patients with intrapulmonary nodules previously localized by CT-scan and flagged percutaneously with a hook-wire. Immediately after the procedure, the patient was transferred to the operating room and thoracoscopic pulmonary wedge resection was performed.


RESULTS
All the nodules were properly identified. The time to position the wire was 20-30 min and thoracotomy could be avoided in all patients. The nodules were 0.5 cm - 6 cm in size and situated 1 cm - 4 cm subpleurally.


CONCLUSIONS
Guide-wire identification of an intrapulmonary nodule is a safe, elegant, time-saving and reliable method. The lack of manual examination of pulmonary parenchyma in thoracoscopy is compensated for by precise pre-operative localization.
Kastl
Sigrid
S
Departments of Surgery and 2Radiology, University of Hamburg, 20246 Hamburg, Germany.
Langwieler
Thomas E
TE
Krupski-Berdien
Gerrit
G
Demir
Ersen
E
Izbicki
Jakob R
JR
D000328:Adult; D000368:Aged; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000556:secondary / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*