title: Successful thoracoscopic resection of pulmonary metastasis less than 1 cm in size utilizing preoperative CT-guided wire localization.
abstract: Preoperative computer tomography (CT) guidance localization utilizing a percutaneous guidewire before thoracoscopic resection is safe and beneficial in children with pulmonary nodules less than 1 cm in size or located deep in the pleural surface. This paper describes a successful thoracoscopic resection of a little subpleural pulmonary metastasis of a Wilm's tumor in a 5-year-old child utilizing preoperative CT-guided wire localization of the lesion. The thoracoscopic procedure was performed with the use of two ports, the nodule was easily localized,and the pulmonary wedge resection was made by the use of an endo-GIA linear stapling device after guidewire removal. The operating time was 45 minutes and the chest tube was removed after 48 hours. The postoperative course was uneventful, and the child was discharged on postoperative day 5. This technique allows the surgeon to resect little pulmonary nodules, avoiding the need of more invasive procedures as standard thoracotomy without adjunctive morbidity and with good cosmetic results.
authors.affiliation: Departments of Pediatric Surgery, Infermi Hospital, Rimini, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Federici
authors.forename: Alberto
authors.initials: A
authors.lastname: Ratta
authors.forename: Mauruzio
authors.initials: M
authors.lastname: Mordenti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Domenichell
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pelusi
authors.forename: Francesco
authors.initials: F
authors.lastname: Italiano
authors.forename: Enrico
authors.initials: E
authors.lastname: Cavagna
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Biagi
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D011300:Preoperative Care; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D009396:Wilms Tumor / Q000473:pathology*