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. 2015 Aug 15:13:248.
doi: 10.1186/s12957-015-0664-9.

Localization of nonpalpable pulmonary nodules using CT-guided needle puncture

Hsian-He Hsu  1 , Chih-Hao Shen  2 , Wen-Chuan Tsai  3 , Kai-Hsiung Ko  1 , Shih-Chun Lee  4 , Hung Chang  4 , Tsai-Wang Huang  5   6
Affiliations

Localization of nonpalpable pulmonary nodules using CT-guided needle puncture

Hsian-He Hsu et al. World J Surg Oncol. .

Abstract

Background: Surgical resection of small pulmonary nodule is challenging via thoracoscopic procedure. We describe our experience of computed tomography (CT)-guided needle puncture localization of indeterminate pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS).

Methods: From January 2011 to July 2014, 78 consecutive patients underwent CT-guided marking for the localization of 91 small pulmonary nodules. We retrospectively reviewed the clinical data, technical details, surgical findings and pathologic results, and complications associated with CT-guided localization.

Results: Seventy-eight consecutive patients (36 men and 42 women) underwent CT-guided marking localization of 91 indeterminate pulmonary nodules (62 pure ground-glass opacity nodules, 27 part-solid nodules, and 2 solid nodules). The mean size of the nodules was 8.6 mm (3.0-23.0 mm). The mean pleural distance between the nodule and lung surface was 11.5 mm (3.0-31.3 mm). The mean procedure time of CT-guided localization was 15.2 min (8-42 min). All patients stood the procedures well without requiring conversion to open thoracotomy. Twenty-four patients (30.77%) developed pneumothorax after the procedures. Only one patient required retention of the puncture needle introducer for air drainage. The mean visual assessment pain score was 1.7 (0-3). Fifty-seven nodules (62.63%) were confirmed as malignances, including 45 primary lung cancer, and 34 nodules (37.37%) were confirmed as benign lesions.

Conclusions: CT-guided needle puncture can be an effective and safe procedure prior to VATS, enabling accurate resection and diagnosis of small pulmonary nodules.

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Figures

Fig. 1
Fig. 1
a The puncture needle (Temno Coaxial Introducer Needle, Care Fusion, PP1910) was inserted under the CT-guided imaging. b Intraoperative identification of the puncture holes at lung surface after one lung ventilation
Fig. 2
Fig. 2
This pulmonary hemorrhage was useful in identification of the target lesion
See this image and copyright information in PMC

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