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  • Title: Percutaneous localization of pulmonary nodules prior to thoracoscopic surgery by CT-guided hook-wire.
    Author: Kastl S, Langwieler TE, Krupski-Berdien G, Demir E, Izbicki JR.
    Journal: Anticancer Res; 2006; 26(4B):3123-6. PubMed ID: 16886644.
    Abstract:
    BACKGROUND: When performing thoracoscopic surgery in patients with small pulmonary nodules, intraoperative localization can be difficult and time-consuming. The percutaneous localization of suspicious intrapulmonary lesions was evaluated pre-operatively to facilitate the resection of the lesion and to avoid thoracotomy. MATERIALS AND METHODS: Thoracoscopies were performed in 13 patients with intrapulmonary nodules previously localized by CT-scan and flagged percutaneously with a hook-wire. Immediately after the procedure, the patient was transferred to the operating room and thoracoscopic pulmonary wedge resection was performed. RESULTS: All the nodules were properly identified. The time to position the wire was 20-30 min and thoracotomy could be avoided in all patients. The nodules were 0.5 cm - 6 cm in size and situated 1 cm - 4 cm subpleurally. CONCLUSION: Guide-wire identification of an intrapulmonary nodule is a safe, elegant, time-saving and reliable method. The lack of manual examination of pulmonary parenchyma in thoracoscopy is compensated for by precise pre-operative localization.
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