title: Fluoroscopy-assisted thoracoscopic resection for small intrapulmonary lesions after preoperative computed tomography-guided localization using fragmented platinum microcoils.
abstract: BACKGROUND
  Preoperative localization is frequently necessary to perform thoracoscopic resection of a small and/or deeply located intrapulmonary lesion. We developed a new method that uses a fragmented platinum microcoil, and retrospectively evaluated the efficacy of our technique.
  
  
  METHODS
  Between January 2006 and May 2010, self-made microcoils (Easimarker) were used to localize total 32 lesions (21 solid nodules, and 11 ground glass opacities) in 30 patients. Computed tomography-guided localization was performed into, or just around the lesions. Localized lesions were resected using fluoroscopy-assisted thoracoscopic surgery (FATS), and the histopathologic diagnosis was confirmed. The accuracy and complications of the localization procedure, and operative results of FATS were observed.
  
  
  RESULTS
  Mean size and depth of all lesions were 11.8 ± 5.1 mm (range: 3 to 22) and 12.2 ± 7.1 mm (range: 2 to 30). CT-guided localizations were successfully performed in all lesions. Four minimal pneumothorax and one parenchymal hematoma related with localization procedure occurred. There were three repeated procedures, which resulted from pleural rebounding of the microcoils. There were two microcoil detecting failures due to intrathoracic displacement during FATS. All 32 resected lesions were histopathologically diagnosed.
  
  
  CONCLUSIONS
  CT-guided localization using the fragmented microcoil combined with FATS of small intrapulmonary lesions is a safe, effective, and a diagnostically accurate procedure.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Paul Hospital, The Catholic University of Korea, Jeonong-dong Dongdaemoon-gu, Seoul, South Korea.
authors.forename: Seok Whan
authors.initials: SW
authors.lastname: Moon
authors.forename: Deog Gon
authors.initials: DG
authors.lastname: Cho
authors.forename: Kyu Do
authors.initials: KD
authors.lastname: Cho
authors.forename: Chul Ung
authors.initials: CU
authors.lastname: Kang
authors.forename: Min Seop
authors.initials: MS
authors.lastname: Jo
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D057918:Fiducial Markers; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden