title: [CT-guided marking of pulmonary nodules with a special lung marking wire before video-assisted thoracoscopic surgery - review of 184 cases].
abstract: OBJECTIVE
  Minimally invasive techniques like video-assisted thoracoscopic surgery (VATS) are currently the method of choice for the resection of small pulmonary nodules, when they are located in the periphery of the lungs. To guarantee quick and safe intraoperative identification of the nodule, preoperative marking is necessary and sensible. We report about our experiences in 184 markings with a special lung marking wire, which is placed in or around the pulmonary nodule using CT guidance.
  
  
  METHODS
  In 184 patients (97 m, 87f, mean age: 58.1 ± 13.7 years) with pulmonary nodules, scheduled for resection with VATS, a special lung marking wire was placed preoperatively under CT guidance. We evaluated the technical success, safety, necessity of conversion to thoracotomy and histology in all patients.
  
  
  RESULTS
  The marking wire could be positioned successfully in 181 cases (98.4 %). There was one major complication (uncontrollable pneumothorax). Minor adverse events like small pneumothorax (53.3 %) or a perifocal bleeding (30.4 %) did not necessitate treatment. Complete resection of the marked nodule was successful in 98.4 % of the patients. Conversion to thoracotomy was necessary in 29 patients (15.9 %) due to bleeding, adhesions, malignancy or wire dislocation. Histology revealed a benign nodule in 96 cases (54.4 %) and a malignant lesion in 78 cases (45.6 %), of which only 21 nodules (11.5 %) turned out to present a primary pulmonary carcinoma.
  
  
  CONCLUSIONS
  CT-guided marking of pulmonary nodules using a special marking wire followed by thoracoscopic resection is an efficient and safe method for diagnosing suspicious nodules in the periphery of the lung.
authors.affiliation: Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig. marie-kristin-schulze@web.de
authors.forename: M-K
authors.initials: MK
authors.lastname: Schulze
authors.forename: U
authors.initials: U
authors.lastname: Eichfeld
authors.forename: T
authors.initials: T
authors.lastname: Kahn
authors.forename: P
authors.initials: P
authors.lastname: Stumpp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001864:Bone Wires; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005260:Female; D057918:Fiducial Markers; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D036542:Tomography, Spiral Computed / Q000379:methods*
chemical_list: D003287:Contrast Media