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Preoperative Localization Using Methylene Blue, Coils, and Per-operative Ultrasound for Small Lung Lesions During Thoracoscopic Surgery

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Abstract

The aim of this study was to ensure that intraparenchymal pulmonary lesions could be reached by video-assisted thoracoscopic surgery (VATS) and to reveal the diagnosis of the lesion by histopathological evaluation when they had the following characteristics: lack of detectability by palpation, size of less than 2 cm in size, appearance of ground-glass opacity, or hard-to-reach localization. To accomplish this, before the operations, thorax computed tomography (CT) marking with methylene blue, coil placement, and intrathoracic ultrasonography methods were used. Patients in the 20–75 age group who have undiagnosed pulmonary lesions, who have the possibility of malignancy, and who are planned to perform VATS were marked with preoperative interventional methods, and the results of these patients were evaluated. The sample included 52 patients, of whom, 13 were women and 39 were men. In 75% (n = 39) of the patients, methylene blue injection was accompanied by preoperative thorax CT. Furthermore, coil application with preoperative thorax CT was used in 11.54% (n = 6) of patients, and intraoperative intrathoracic ultrasonography marking was employed in 13.46% (n = 7) of patients. Nodules that are suitable to be removed with the marking techniques used can easily be detected, even with VATS. In the preoperative period, thorax CT–guided methylene blue injection and pulmonary nodule marking with coil and intraoperative intrathoracic ultrasonography or pulmonary nodule techniques are reliable, effective, and interventional methods that make surgery easier and safer. 

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Data Availability

The authors confirm that the data supporting the findings of this study are available within the article and supplementary materials. Additional data may be available upon request for some of the participating centers but not for all due to relevant data protection laws.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kayseri City Research and Training Hospital, Kayseri, Turkey

    Selma Mine Kara Apaydın

  2. Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital, Ankara, Turkey

    Sevki Mustafa Demıroz, Koray Aydogdu, Hakan Erturk, Funda Incekara, Sadi Kaya & Gokturk Fındık

  3. Department of Radiology, Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital, Ankara, Turkey

    Hakan Erturk

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  1. Selma Mine Kara Apaydın
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  2. Sevki Mustafa Demıroz
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Correspondence to Selma Mine Kara Apaydın.

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Ethics committee aproval was obtained from Ethics Committee of Ankara Keçiören Training and Research Hospital (decision no. 2012-KAEK-15/1655 on 25.04.2018).

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Apaydın, S.M.K., Demıroz, S.M., Aydogdu, K. et al. Preoperative Localization Using Methylene Blue, Coils, and Per-operative Ultrasound for Small Lung Lesions During Thoracoscopic Surgery. Indian J Surg 85 (Suppl 2), 459–464 (2023). https://doi.org/10.1007/s12262-023-03715-1

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  • DOI: https://doi.org/10.1007/s12262-023-03715-1

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