Skip to main content

Advertisement

SpringerLink
Log in

Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Since the introduction of lung nodule radio-guided localization, multiport video-assisted thoracoscopic surgery resection has been widely described. To date, only one series has reported the use of uniportal approach. Our objective is to describe the experience of a single institution of lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection. Retrospective cohort study based on data from medical records of patients between May 2012 and April 2019. Twenty-four patients were included, 13 were women (54.2%) with a median age of 59.5 years (range 19 and 81 years). Median nodule size was 7 mm (range 3–12 mm) and 19 (79.2%) patients had single lung nodule. The main indication was sub-centimetric nodule in 22 (91.6%) patients followed by a deep localization in 10 (41.6%) patients and sub-solid nodule in 9 (37.5%) patients. Median surgical time was 102.5 min (range 55–160 min). 4 (16.6%) patients had malignant neoplasm of the lung, 10 (41.7%) patients had lung metastases and 10 (41.7%) patients had benign lung lesions. The success rate found was 95.8%. Concordance analysis between palpation of the pulmonary nodule and the presence of the nodule in the histopathology was rated as poor, kappa value − 0.71 (P = 0.186) and between the resection of the pulmonary nodule according to the presence of the nodule in the pathology report was rated as good, Kappa value 0.625 (P = 0.001). Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection has a similar success rate and complications to those described by multiport video-assisted thoracoscopic surgery resections.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chella A, Lucchi M, Ambrogi MA, Menconi G, Melfi FM, Gonfiotti A, Boni G, Angeletti CA (2000) A pilot study of the role of TC-99 radionuclide in localization of pulmonary nodular lesions for thoracoscopic resection. Eur J Cardiothorac Surg 18:17–21

    Article  CAS  PubMed  Google Scholar 

  2. Dailey WA, Frey GT, McKinney JM, Paz-Fumagalli R, Sella D, Toskich B, Thomas M (2018) Percutaneous computed tomography-guided radiotracer-assisted localization of difficult pulmonary nodules in uniportal video-assisted thoracic surgery. J Laparoendosc Surg 28(12):1451–1457

    Article  Google Scholar 

  3. Daniel TM, Altes TA, Rehm PK, Williams M, Jones D, Stolin A, Gay S (2004) A novel technique for localization and excisional biopsy of small or Ill-defined pulmonary lesions. Ann Thorac Surg 77(5):1756–1762

    Article  PubMed  Google Scholar 

  4. Gonzalez D, Paradela M, Garcia J, De-la-Torre M (2011) Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg 12:514–516

    Article  PubMed  Google Scholar 

  5. Lin MW, Tseng YH, Lee YF, Hsieh MS, Ko WC, Chen JY, Hsu HH, Chang YC, Chen JS (2016) Computed tomography-guided patent blue vital dye localization of pulmonary nodules in uniportal thoracoscopy. J Thorac Cardiovasc Surg 152(2):535–544

    Article  PubMed  Google Scholar 

  6. Shi Z, Chen C, Jiang S, Jiang G (2016) Uniportal video-assisted thoracic surgery resection of small ground-glass opacities (GGOs) localized with CT-guided placement of microcoils and palpation. J Thorac Dis 8:1837–1840

    Article  PubMed  PubMed Central  Google Scholar 

  7. Zhao ZR, Lau R, Ng C (2017) Hybrid theater and uniportal video-assisted thoracic surgery: the perfect match for lung nodule localization. Thorac Surg Clin 27:347–355

    Article  PubMed  Google Scholar 

  8. Sihoe A (2017) Are there contraindications for uniportal video-assisted thoracic surgery? Thorac Surg Clin 27:373–380

    Article  PubMed  Google Scholar 

  9. Gonzalez-Rivas D, Sihoe A (2017) Important technical details during uniportal video-assisted thoracoscopic major resections. Thorac Surg Clin 27:357–372

    Article  PubMed  Google Scholar 

  10. Grogan E, Jones D, Kozower B, Simmons W, Daniel T (2008) Identification of small lung nodules: technique of radiotracer-guided thoracoscopic biopsy. Ann Thorac Surg 85:S772–S777

    Article  PubMed  Google Scholar 

  11. Galeta D, Bellomi M, Grana C, Spaggiari L (2015) Radio-guided localization and resection of small or ill-defined pulmonary lesions. Ann Thorac Surg 100:1175–1180

    Article  Google Scholar 

  12. Gonfiotti A, Davini F, Vaggelli L, De-Francisci A, Caldarella A, Gigli PM, Janini A (2007) Thoracoscopic localization techniques for patients with solitary pulmonary nodule: hookwire versus radio-guided surgery. Eur J Cardiothorac Surg 32:843–847

    Article  PubMed  Google Scholar 

  13. Ricciardi S, Davini F, Manca G, De-Liperi A, Romano G, Zirafa CC, Melfi F (2020) Radioguided surgery, a cost-effective strategy for treating solitary pulmonary nodules: 20 year experience of a single center. Clin Lung Cancer. https://doi.org/10.1016/j.cllc.2020.02.026

    Article  PubMed  Google Scholar 

  14. Stiles BM, Altes TA, Jones DR, Shen R, Ailawadi G, Gay S, Olazagasti J, Rehm P, Daniel T (2006) Clinical experience with radiotracer-guided thoracoscopic biopsy of small, indeterminate lung nodules. Ann Thorac Surg 82(4):1191–1197

    Article  PubMed  Google Scholar 

  15. Grogan EL, Stukenborg GJ, Nagji AS, Simmons W, Kozower B, Jones D, Daniel T (2008) Radiotracer-guided thoracoscopic resection is a cost-effective technique for the evaluation of subcentimeter pulmonary nodules. Ann Thorac Surg 86(3):934–940

    Article  PubMed  Google Scholar 

  16. Starnes SL, Wolujewicz M, Guitron J, Williams V, Scheler J, Ristagno R (2018) Radiotracer localization of nonpalpable pulmonary nodules: a single-center experience. J Thorac Cardiovasc Surg 156(5):1986–1992

    Article  PubMed  Google Scholar 

  17. Suzuki K, Nagai K, Yoshida J, Ohmatsu H, Takahashi K, Nishimura M, Nishiwaki Y (1999) Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest 115(2):563–568

    Article  CAS  PubMed  Google Scholar 

  18. Bellomi M, Veronesi G, Trifirò G, Bambilla S, Bonello L, Preda L, Casiraghi BA, Paganelli G, Spaggiari L (2010) Computed tomography-guided preoperative radiotracer localization of nonpalpable lung nodules. Ann Thorac Surg 90(6):1759–1764

    Article  PubMed  Google Scholar 

  19. Durmo R, Lechiara M, Benetti D, Rodella C, Camoni L, Albano D, Bertagna F, Giubbini R (2019) Radioguided lung lesion localization: introducing a fluoroscopy system in a SPECT/CT scan. Nucl Med Commun 40(6):597–603

    Article  PubMed  Google Scholar 

  20. Ambrogi MC, Melfi F, Zirafa C, Lucchi M, De-Liperi A, Mariani G, Fanucchi O, Mussi A (2012) Radio-guided thoracoscopic surgery (RGTS) of small pulmonary nodules. Surg Endosc 26(4):914–919

    Article  PubMed  Google Scholar 

  21. Abouarab AA, Rahouma M, Kamel M, Ghaly G, Mohamed A (2018) Single versus multi-incisional video-assisted thoracic surgery: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A 28(2):174–185. https://doi.org/10.1089/lap.2017.0446 (Epub 2017 Nov 6 PMID: 29106318)

    Article  PubMed  Google Scholar 

  22. Yan Y, Huang Q, Han H, Zhang Y, Chen H (2020) Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis. J Cardiothorac Surg 15(1):238. https://doi.org/10.1186/s13019-020-01280-2

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Special thanks to Andres Jimenez and Faustino Bastidas with whom we performed the first case of lung nodule radio-guided localization and multiport VATS resection in 2012 at the INC.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Thoracic Surgeon, Thoracic Surgery Department, Instituto Nacional de Cancerología, Calle 1 No. 9-85, Bogotá, Colombia

    Carlos Carvajal, Rafael Beltrán & Ricardo Buitrago

  2. Oncologic surgeon, Surgical Oncology Department, Instituto Nacional de Cancerología, Bogotá, Colombia

    Felipe González

  3. Nuclear Medicine Department, Instituto Nacional de Cancerología, Bogotá, Colombia

    Amelia de los Reyes & Augusto Llamas

  4. Interventional Radiologist, Radiology Department, Instituto Nacional de Cancerología, Bogotá, Colombia

    Julián Beltrán

  5. Research Department, Instituto Nacional de Cancerología, Bogotá, Colombia

    José Carreño

Authors
  1. Carlos Carvajal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Felipe González
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rafael Beltrán
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ricardo Buitrago
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amelia de los Reyes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Augusto Llamas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Julián Beltrán
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. José Carreño
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by CC, FG, RB, RB, AR, AL, JB, and JC. The first draft of the manuscript was written by CC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Carlos Carvajal.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Availability of data and material

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Carvajal, C., González, F., Beltrán, R. et al. Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection. Updates Surg 73, 1559–1566 (2021). https://doi.org/10.1007/s13304-020-00953-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-020-00953-w

Keywords

Search

Navigation