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. 2019 May 12:2019:5383086.
doi: 10.1155/2019/5383086. eCollection 2019.

Uniportal VATS Coil-Assisted Resections for GGOs

Maria Teresa Congedo  1   2 , Roberto Iezzi  2   3 , Dania Nachira  1   2 , Anna Rita Larici  2   3 , Marco Chiappetta  1   2 , Lucio Calandriello  2   3 , Maria Letizia Vita  1   2 , Elisa Meacci  1   2 , Venanzio Porziella  1   2 , Mahmoud Ismail  4 , Riccardo Manfredi  2   3 , Stefano Margaritora  1   2
Affiliations

Uniportal VATS Coil-Assisted Resections for GGOs

Maria Teresa Congedo et al. J Oncol. .

Abstract

Backgrounds: Although uniportal video-assisted thoracic surgery (VATS) theoretically allows the direct palpation of any zone of the lung through a small incision, sometimes it can be difficult to localize pure ground-glass opacities anyway. The aim of this study is to evaluate the usefulness and safety of preoperative computed tomography (CT)-guided microcoil localization of GGO nodules in patients undergoing uniportal VATS lung resection.

Methods: The clinical data and CT images of 30 consecutive patients (30 pulmonary nodules) who underwent preoperative CT-guided coil localization and subsequent uniportal VATS resection, from January 2017 to October 2018, were reviewed.

Results: All the CT-localization procedures have been performed with success (30/30) and the mean procedure time was 35±15 minutes. The mean size of the nodules was 15,53±6,72 mm, and the mean distance of the nodules from the pleural surface was 19,08±12,08 mm. Eleven nodules (36,7%) were pure ground-glass opacities and 19 (63,3%) were mixed ground-glass with a solid component of 50% or more. In 5 cases, the localization procedure was complicated by asymptomatic pneumothoraxes and in 1 case the pneumothorax required chest tube insertion. In any case a conversion to thoracotomy was avoided because all nodules were identified and resected through uniportal VATS.

Conclusions: Preoperative CT-guided coil localization seems to be a feasible, safe, and accurate procedure. It makes uniportal VATS an easy approach even for resecting small, deep, and impalpable nodules.

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Figures

Figure 1
Figure 1
CT-images showing nodule localization by microcoil in different scanning planes.
Figure 2
Figure 2
Radiological (a) and intraoperative (b) view of the microcoil deployed partially inside the nodule and partially along the visceral pleura.
Figure 3
Figure 3
Appearance of the microcoil (yellow arrow) inside the specimen sectioned by the pathologist (blue arrows indicate the nodule sectioned).
See this image and copyright information in PMC

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