Need for preoperative computed tomography-guided localization in video-assisted thoracoscopic surgery pulmonary resections of metastatic pulmonary nodules

The Annals of Thoracic Surgery
Shinji NakashimaTetsuya Higami

Abstract

Preoperative localization of pulmonary nodules is sometimes necessary when they are too small or distant from the surface of the visceral pleura to be detected during video-assisted thoracoscopic surgery. This study aims to present the criteria for localization and to evaluate the accuracy of the criteria. From April 2001 to March 2008, 178 patients with 224 nodules who underwent wedge resection of pulmonary metastatic nodules by video-assisted thoracoscopic surgery were reviewed retrospectively. Thirty-one patients (17.4%) including 35 nodules underwent thoracoscopic resection immediately after computed tomography-guided localization using hook wires. Criteria for preoperative localization were (1) maximum diameter of the nodule of 5 mm or less, (2) maximum diameter to minimum distance between the visceral pleura and inferior border of nodule of 0.5 or less, and (3) nodule with low-density image by computed tomography after chemotherapy. The accuracy of these inclusion criteria was statistically evaluated. All 224 nodules were removed by wedge resection or additional segmentectomy. Nineteen nodules (54.3%) were detected in the thoracic cavity with preoperative localization. Sensitivity, specificity, positive predictive value, ...Continue Reading

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Citations

Apr 15, 2014·The Annals of Thoracic Surgery·Manu S SanchetiSeth D Force
Dec 10, 2013·The Annals of Thoracic Surgery·Sébastien BommartHélène Kovacsik
Jul 31, 2013·The Annals of Thoracic Surgery·Junji IchinoseSouichiro Suzuki
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Jan 4, 2020·Interactive Cardiovascular and Thoracic Surgery·Kazuhiro ItoMasayoshi Inoue
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