title: Extratumoral spiral fixed wire marking of small pulmonary nodules for thoracoscopic resection.
abstract: BACKGROUND
  Video-assisted thoracoscopic surgery (VATS) for pulmonary nodules close to the visceral pleura is an established procedure. Different methods have been developed to mark these nodules when resecting small nodules distant to the pleural surface. The possibility of tumor cell spread due to nodule penetration is a major drawback. Furthermore, guide wire-based marking systems have revealed the problem of accidental wire dislocation prior to resection.
  
  
  METHODS
  In this study, a new marker system for computed tomography-guided extranodular spiral fixed wire marking (ESFWM) was evaluated in an attempt to maintain tumor integrity while reducing the risk of wire dislocation.
  
  
  RESULTS
  Our study included 42 patients with 44 marked nodules. 40 nodules were resected by VATS in 38 of these patients. The remaining 4 patients required conversion to thoracotomy due to adhesions and a non-deflated lung. Wire dislocation and nodule penetration occurred only once.
  
  
  CONCLUSIONS
  The new lung marker system revealed a very low risk of wire dislocation. Peritumoral marking allows the safe resection of subpleural nodules without a risk of tumor cell spread.
authors.affiliation: Department of General and Thoracic Surgery, University Giessen, Giessen, Germany. markus.hirschburger@chiru.med.uni-giessen.de
authors.forename: M
authors.initials: M
authors.lastname: Hirschburger
authors.forename: S
authors.initials: S
authors.lastname: Sauer
authors.forename: T
authors.initials: T
authors.lastname: Schwandner
authors.forename: W
authors.initials: W
authors.lastname: Schief
authors.forename: T
authors.initials: T
authors.lastname: Kuchenbuch
authors.forename: C
authors.initials: C
authors.lastname: Zoerb
authors.forename: H
authors.initials: H
authors.lastname: Janssen
authors.forename: V
authors.initials: V
authors.lastname: Grau
authors.forename: W
authors.initials: W
authors.lastname: Stertmann
authors.forename: W S
authors.initials: WS
authors.lastname: Rau
authors.forename: W
authors.initials: W
authors.lastname: Padberg
mesh_terms: D004867:Equipment Design; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000295:instrumentation* / Q000379:methods; D011859:Radiography; D015642:Radiology, Interventional; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*