title: Video-Assisted Thoracoscopic Surgery after Preoperative CT-Guided Lipiodol Marking of Small or Impalpable Pulmonary Nodules.
abstract: OBJECTIVE
  Small pulmonary lesions that include ground-glass attenuation have been increasingly discovered because of progressive imaging diagnostic technologies. Despite the detection of such small lesions, sometimes it is quite difficult to localize them because of their size or considerable depth from the visceral pleura. In the present study, we examined the usefulness of computed tomography-guided lipiodol marking for thoracoscopic resection of impalpable pulmonary nodules.
  
  
  METHODS
  Fifty-six patients with an undiagnosed peripheral lesion(s) of the lung who had undergone preoperative computed tomography-guided lipiodol marking followed by video-assisted thoracoscopic surgery were studied.
  
  
  RESULTS
  All of the nodules were successfully marked by computed tomography-guided lipiodol marking, and all except for one case were localized by means of intraoperative fluoroscopy as clear spots. With regard to complications, pneumothorax occurred in 21 patients (37.5%), and only one patient required transient drainage. Although hemorrhaging in the lung parenchyma and hemosputum occurred in nine patients (16.1%) and one patient (1.8%), respectively, no patients were in serious condition. No intra- or postoperative mortality or morbidity was observed.
  
  
  CONCLUSIONS
  Preoperative computed tomography-guided lipiodol marking of small or impalpable pulmonary nodules is a safe and useful procedure for thoracoscopic resection of the lung.
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Mogi
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yajima
authors.forename: Kenji
authors.initials: K
authors.lastname: Tomizawa
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Onozato
authors.forename: Shigebumi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004998:Ethiodized Oil; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D004998:Ethiodized Oil