title: A Simple and Safe Technique for CT Guided Lung Nodule Marking prior to Video Assisted Thoracoscopic Surgical Resection Revisited.
abstract: Aim. We describe our experience of a simple, safe, and reproducible technique for lung nodule marking prethoracoscopic metastasectomy. Thoracoscopic lung nodule resection reduces patient discomfort, complications, higher level of care, hospital stay, and cost; however, small deeply placed lung nodules are difficult to locate and resect thoracoscopically. Materials and Methods. We describe and review the success of our novel technique, where nodules are identified on a low dose CT and marked with methylene blue using CT fluoroscopy guidance immediately prior to surgery. Results. 30 nodules were marked with a mean size of 8 mm (4-18 mm) located at a mean depth of 17 mm, distributed through both lungs. Dye was detected at the pleural surface in 97% of the patients and at the nodule in 93%. There were no major complications. Thoracoscopic resection was possible in 90%. Conclusion. This is a simple and safe method of lung nodule marking to facilitate thoracoscopic resection in cases where this may not be technically possible due to nodule location.
authors.affiliation: Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK.
authors.forename: James A
authors.initials: JA
authors.lastname: Stephenson
authors.affiliation: Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK.
authors.forename: Ayman
authors.initials: A
authors.lastname: Mahfouz
authors.affiliation: Department of Thoracic Surgery, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK.
authors.forename: Sridhar
authors.initials: S
authors.lastname: Rathinam
authors.affiliation: Department of Thoracic Surgery, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Nakas
authors.affiliation: Department of Radiology, Glenfield General Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK.
authors.forename: Amrita
authors.initials: A
authors.lastname: Bajaj