Protection of the mediastinum and chest wall with an artificial pneumothorax during lung ablations.
The objective in creating an artificial pneumothorax during lung ablation is to develop a working space in the thorax sufficient to displace the target lung lesion from adjacent vulnerable mediastinal or chest wall structures. Attempts to induce a protective pneumothorax with the use of spring-loaded needles were successful in four of six patients, permitting development of safe "windows" for ablation. These pneumothoraces were induced by the introduction of a needle with a spring-loaded, blunt-tipped obturator into the pleural space, followed by injection of room air. Pleural adhesions related to previous interventions may interfere with creation of a pneumothorax. Use of this technique could extend the utility of ablative therapies for lesions adjacent to the mediastinum and chest wall.
Solomon
Stephen B
SB
Section of Interventional Radiology and Image-Guided Therapies, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-210, New York, NY 10021, USA. solomons@mskcc.org <solomons@mskcc.org>
Thornton
Raymond H
RH
Dupuy
Damian E
DE
Downey
Robert J
RJ
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D011031:Pneumothorax, Artificial / Q000295:instrumentation*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D035441:Thoracic Wall; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome