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Ann Thorac Surg 2005;79:313-316
© 2005 The Society of Thoracic Surgeons

New technology

Video-Assisted Thoracoscopic Surgery for Pulmonary Nodules After Computed Tomography-Guided Marking With a Spiral Wire

Uwe Eichfeld, MD, PhDa,*, Arne Dietrich, MDa, Rudolph Ott, MD, PhDa, Rainer Kloeppel, MD, PhDb

a Clinic for Abdominal, Transplant, Vascular and Thoracic Surgery, Leipzig University, Leipzig, Germany
b Department of Diagnostic Radiology, Leipzig University, Leipzig, Germany

Accepted for publication October 20, 2003.

* Address reprint requests to Dr Eichfeld, Universität Leipzig, Chirurg Klinik II, Liebigstr 20a, 04103 Leipzig, Germany
eichu{at}medizin.uni-leipzig.de

PURPOSE: Peripheral pulmonary nodules are preferably removed by minimally invasive techniques, such as video-assisted thoracoscopic (VATS) surgery. These nodules should be marked preoperatively for better intraoperative detection and removal.

DESCRIPTION: Twenty-two cases with a single pulmonary nodule requiring surgical removal for histologic examination were included in a prospective study. Guided by computed tomography, nodules were marked preoperatively using a laser marker system and fixed with a spiral wire. The marked nodules were removed by VATS surgery immediately after the marking.

EVALUATION: The marking wire was placed in all 22 patients without any complications. The marked nodule was completely removed by VATS surgery in 19 patients. Conversion to thoracotomy was necessary in 3 patients, twice because of thoracoscopy-related problems and once because of a marking failure. The average times for the marking procedure and operation were 24 minutes and 32 minutes, respectively.

CONCLUSIONS: This new method of computed tomography-guided nodule marking with a spiral wire and subsequent VATS surgery is very efficient in terms of localization and stable fixation of subpleural pulmonary nodules.


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INVITED COMMENTARY
Jeffrey M. Piehler
Ann. Thorac. Surg. 2005 79: 316-317. [Extract] [Full Text] [PDF]



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