title: Value of radial probe endobronchial ultrasound-guided localization of solitary pulmonary nodules with the combination of ultrathin bronchoscopy and methylene blue prior to video-assisted thoracoscopic surgery.
abstract: The aim of this study was to assess the clinical value of radial probe endobronchial ultrasound (RP-EBUS)-guided localization of solitary pulmonary nodules (SPNs) with the combination of ultrathin bronchoscopy and methylene blue prior to video-assisted thoracoscopic surgery (VATS). An ultrathin bronchoscope was used to localize the lesions under RP-EBUS guidance in 48 patients (18 men and 30 women; age range, 41-72 years; mean age, 54 years), who subsequently underwent VATS resection. The lesion size, distance from the parietal pleura, localization time and complications were evaluated. The RP-EBUS-guided localization success rate was 72.9%. The lesion size ± standard deviation was 12.8±4.2 mm and the mean distance from the parietal pleura was 11.2±9.7 mm. The mean localization time was 15.7±8.3 min. The major complication of RP-EBUS-guided localization was asymptomatic hemorrhage in 4 patients (8.3%). The VATS resection success rate was 95.8%. In terms of pathological type, the 48 lesions included atypical adenomatous hyperplasia (n=4), adenocarcinomain situ(n=5), minimally invasive adenocarcinoma (n=7), adenocarcinoma (n=18), squamous cell carcinoma (n=1), inflammation (n=6), hamartoma (n=4) and tuberculosis (n=3). Therefore, RP-EBUS-guided localization with the combination of an ultrathin bronchoscope and methylene blue prior to VATS resection is a promising technique for SPNs, it plays an important role in the accurate localization of SPNs and it is an effective and safe technique to assist VATS resection of such nodules.
authors.affiliation: Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P.R. China; Nanjing Clinical Center of Respiratory Diseases and Imaging, Nanjing, Jiangsu 210029, P.R. China.
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Xu
authors.affiliation: Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P.R. China; Nanjing Clinical Center of Respiratory Diseases and Imaging, Nanjing, Jiangsu 210029, P.R. China.
authors.forename: Li-Ke
authors.initials: LK
authors.lastname: Yu
authors.affiliation: Nanjing Clinical Center of Respiratory Diseases and Imaging, Nanjing, Jiangsu 210029, P.R. China.
authors.forename: Lan
authors.initials: L
authors.lastname: Cao
authors.affiliation: Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P.R. China.
authors.forename: Rusong
authors.initials: R
authors.lastname: Yang
authors.affiliation: MOE Key Laboratory, Model Animal Research Center, Nanjing University, Nanjing, Jiangsu 210061, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P.R. China.
authors.forename: Zheng-Cheng
authors.initials: ZC
authors.lastname: Liu
authors.affiliation: Department of Radiology, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
keywords: localization; radial probe endobronchial ultrasound-guided bronchoscopy; solitary pulmonary nodule; video-assisted thoracoscopic surgery