title: Thoracoscopic resection of computed tomography-localized lung nodules in children.
abstract: OBJECTIVE
  Detection and treatment of small lung nodules are important in managing pediatric cancer. We studied the effectiveness of preoperative localization of pulmonary nodules by CT-guided needle hook wire placement followed by thoracoscopic resection in children with cancer.
  
  
  METHODS
  We reviewed records of patients who underwent thoracoscopic resection of lung nodules localized preoperatively with CT-guided needle and hook wire placement at our hospital between March 1999 and April 2010 for nodule characteristics and outcomes of procedure.
  
  
  RESULTS
  Thirty-seven patients (median age, 14years) with osteosarcoma or other cancers underwent thoracoscopic resection of needle-localized lung nodules. Lesion (median nodule size, 4mm) location was left lung (n=11), right lung (n=19), and bilateral (n=7). The procedure was successful in 36 (97.3%) patients. Five patients had a pneumothorax after localization but none required chest tube placement before thoracoscopy. All patients underwent thoracoscopy, but 4 required conversion to open thoracotomy. During thoracoscopic inspection, the hook wire slipped out of the lesion in 6 patients, of whom 1 needed thoracotomy to locate nodule. Lesions (malignant in 13 patients) were removed in all patients. Five patients with benign lesions had recurrent malignant lung nodules.
  
  
  CONCLUSIONS
  Thoracoscopic resection of preoperatively localized small lung nodules is a safe and effective procedure in children.
authors.affiliation: Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
authors.forename: Lalit
authors.initials: L
authors.lastname: Parida
authors.forename: Israel
authors.initials: I
authors.lastname: Fernandez-Pineda
authors.forename: John
authors.initials: J
authors.lastname: Uffman
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Davidoff
authors.forename: Robert
authors.initials: R
authors.lastname: Gold
authors.forename: Bhaskar N
authors.initials: BN
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D015641:Radiography, Interventional; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult