Acta Medica Okayama volume75 issue1
2021-02 発行

Thoracoscopic Localization of Small Peripheral Pulmonary Lesions Using Percutaneous Computed Tomography-guided Pleural Dye Marking: A Retrospective Analysis

Kubo, Yujiro Department of Thoracic Surgery, Iwakuni Clinical Center
Watanabe, Mototsugu Department of Thoracic Surgery, Iwakuni Clinical Center
Choshi, Haruki Department of Thoracic Surgery, Iwakuni Clinical Center
Matsubara, Kei Department of Thoracic Surgery, Iwakuni Clinical Center
Shiotani, Toshio Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kataoka, Kazuhiko Department of Thoracic Surgery, Iwakuni Clinical Center
Publication Date
2021-02
Abstract
Small pulmonary lesions are often difficult to localize during thoracoscopic surgery. We describe a new com-puted tomography (CT)-guided pleural dye-marking method for small peripheral pulmonary lesions that does not involve a visceral pleural puncture. We used this technique for 23 lesions (22 patients) who underwent tho-racoscopic partial lung resection (Nov. 2016-Jan. 2018). With the patient in the lateral decubitus position, pre-operative CT-guided marking on the skin over the lesion was performed. During the surgery, we marked the visceral pleura with a skin marker directly or with an infant-size nutrition catheter with crystal violet at the tip through a venous indwelling needle inserted perpendicular to the skin marking. We localized and resected the lesions in all cases, without complications. The median nodule size measured histopathologically was 8 (4-20) mm overall, and 7 (0-20) mm of the solid part; the median distance from the visceral pleura to the nodule was 9 (1-33) mm. The median operation time was 67 (37-180) min. The median postoperative hospital stay was 3 (3-11) days. Our CT-guided pleural dye-marking method is useful and safe for the localization of small periph-eral pulmonary lesions in thoracoscopic partial lung resections.
Document Type
Original Article
Keywords
Small pulmonary lesion
ground glass nodule
marking
localization
thoracocentesis
Link to PubMed
75_1_55.pdf 12.4 MB