Skip to main content

Advertisement

SpringerLink
Log in

Intraoperative core needle biopsy under complete video-assisted thoracic surgery for indeterminate tumor of lung

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The accuracy, feasibility, and safety of intraoperative core needle biopsy under complete video-assisted thoracic surgery (VATS) (V-CNB) for indeterminate tumors are examined retrospectively, as well as the possibility of pleural dissemination.

Methods

The diagnostic yield and complications of V-CNB were evaluated for a total of 95 patients who underwent V-CNB for indeterminate tumor during the period of April 2002 through March 2012. Moreover, operation time, number of auto-suture instruments used for resection of the lung, and pleural dissemination were compared between the patients who underwent V-CNB (n = 44) and those who did not (n = 87, non-V-CNB) among stage I primary lung cancer patients, for whom lobectomy was performed under complete VATS during the same period.

Results

Of the 95 patients, eighty three had primary lung cancer, four had metastatic lung cancer, and eight had benign tumor. Sensitivity, specificity, and accuracy were 94.3, 87.5, and 93.7 %, respectively. There were no complications associated with V-CNB. Among stage I primary lung cancer, for which lobectomy and lymph node dissection were performed, there was no significant difference between the V-CNB group and the non-V-CNB group for tumor size (23.5 and 24.7 mm, p = 0.482), distance between pleura and tumor (3.4 and 5.0 mm, p = 0.202), operation time (228 and 217 min, p = 0.186), and number of auto-suture instruments used for resection of the lung (4.77 and 4.61, p = 0.533). There was no pleural dissemination in the V-CNB group, although there were two cases (2.3 %) in the non-V-CNB group.

Conclusion

V-CNB diagnosed small-sized indeterminate lung tumors accurately during complete VATS operation, without any complications. V-CNB can reduce the use of auto-suture instruments necessary for performing wedge resection on frozen section diagnosis prior to lobectomy without increasing operation time and the risk of pleural dissemination.

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

Similar content being viewed by others

References

  1. Allen MS, Deschamps C, Lee RE, Trastek VF, Daly RC, Pairolero PC (1993) Video-assisted thoracoscopic stapled wedge excision for indeterminate pulmonary nodules. J Thorac Cardiovasc Surg 106:1048–1052

    CAS  PubMed  Google Scholar 

  2. Murasugi M, Onuki T, Ikeda T, Kanzaki M, Nitta S (2001) The role of video-assisted thoracoscopic surgery in the diagnosis of the small peripheral pulmonary nodule. Surg Endosc 15:734–736

    Article  CAS  PubMed  Google Scholar 

  3. Nishiyama N, Nagano K, Izumi N, Tei K, Hanada S, Komatsu H, Suehiro S (2012) Lobectomy for indeterminate lung tumors with a strong suspicion of lung cancer. Ann Thorac Cardiovasc Surg 18:243–246

    Article  PubMed  Google Scholar 

  4. Schuchert MJ, Abbas G, Awais O, Pennathur A, Nason KS, Wilson DO, Siegfried JM, Luketich JD, Landreneau RJ (2012) Anatomic segmentectomy for the solitary pulmonary nodule and early-stage lung cancer. Ann Thorac Surg 93:1780–1785

    Article  PubMed  Google Scholar 

  5. DeCaro LF, Pak HY, Yokota S, Teplitz RL, Benfield JR (1983) Intraoperative cytodiagnosis of lung tumors by needle aspiration. J Thorac Cardiovasc Surg 85:404–408

    CAS  PubMed  Google Scholar 

  6. Cappellari JO, Thompson EN 3rd, Wallenhaupt SL (1994) Utility of intraoperative fine needle aspiration biopsy in the surgical management of patients with pulmonary masses. Acta Cytol 38:707–710

    CAS  PubMed  Google Scholar 

  7. Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P (2000) Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest 117:1049–1054

    Article  CAS  PubMed  Google Scholar 

  8. Makris D, Scherpereel A, Leroy S, Bouchindhomme B, Faivre JB, Remy J, Ramon P, Marquette CH (2007) Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J 29:1187–1192

    Article  CAS  PubMed  Google Scholar 

  9. Gildea TR, Mazzone PJ, Karnak D, Meziane M, Mehta AC (2006) Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med 174:982–989

    Article  PubMed Central  PubMed  Google Scholar 

  10. Tsukada H, Satou T, Iwashima A, Souma T (2000) Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. Am J Roentgenol 175:239–243

    Article  CAS  Google Scholar 

  11. Wang Y, Li W, He X, Li G, Xu L (2014) Computed tomography-guided core needle biopsy of lung lesions: diagnostic yield and correlation between factors and complications. Oncol Lett 7:288–294

    PubMed Central  PubMed  Google Scholar 

  12. Yao X, Gomes MM, Tsao MS, Allen CJ, Geddie W, Sekhon H (2012) Fine-needle aspiration biopsy versus core-needle biopsy in diagnosing lung cancer: a systematic review. Curr Oncol 19:e16–e27

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Tomiyama N, Yasuhara Y, Nakajima Y, Adachi S, Arai Y, Kusumoto M, Eguchi K, Kuriyama K, Sakai F, Noguchi M, Murata K, Murayama S, Mochizuki T, Mori K, Yamada K (2006) CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol 59:60–64

    Article  PubMed  Google Scholar 

  14. Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD (2003) CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology 229:475–481

    Article  PubMed  Google Scholar 

  15. Yeow KM, Su IH, Pan KT, Tsay PK, Lui KW, Cheung YC, Chou AS (2004) Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest 126:748–754

    Article  PubMed  Google Scholar 

  16. McCarthy WJ, Christ ML, Fry WA (1980) Intraoperative fine needle aspiration biopsy of thoracic lesions. Ann Thorac Surg 30:24–29

    Article  CAS  PubMed  Google Scholar 

  17. Greif J, Marmor S, Schwarz Y, Staroselsky AN (1999) Percutaneous core needle biopsy vs. fine needle aspiration in diagnosing benign lung lesions. Acta Cytol 43:756–760

    Article  CAS  PubMed  Google Scholar 

  18. 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 115:563–568

    Article  CAS  PubMed  Google Scholar 

  19. Liebens F, Carly B, Cusumano P, Van Beveren M, Beier B, Fastrez M, Rozenberg S (2009) Breast cancer seeding associated with core needle biopsies: a systematic review. Maturitas 62:113–123

    Article  PubMed  Google Scholar 

  20. Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF (2008) Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut 57:1592–1596

    Article  CAS  PubMed  Google Scholar 

  21. Cannon SR, Dyson PHP (1987) Relationship of the site of open biopsy of malignant bone tumors to local recurrence following resection and prosthetic replacement. J Bone Joint Surg Br 69:492

    Google Scholar 

  22. Yoshikawa T, Yoshida J, Nishimura M, Yokose T, Nishiwaki Y, Nagai K (2000) Lung cancer implantation in the chest wall following percutaneous fine needle aspiration biopsy. Jpn J Clin Oncol 30:450–452

    Article  CAS  PubMed  Google Scholar 

  23. Matsuguma H, Nakahara R, Kondo T, Kamiyama Y, Mori K, Yokoi K (2005) Risk of pleural recurrence after needle biopsy in patients with resected early stage lung cancer. Ann Thorac Surg 80:2026–2031

    Article  PubMed  Google Scholar 

  24. Inoue M, Honda O, Tomiyama N, Minami M, Sawabata N, Kadota Y, Shintani Y, Ohno Y, Okumura M (2011) Risk of pleural recurrence after computed tomographic-guided percutaneous needle biopsy in stage I lung cancer patients. Ann Thorac Surg 91:1066–1071

    Article  PubMed  Google Scholar 

  25. Ibukuro K, Tanaka R, Takeguchi T, Fukuda H, Abe S, Tobe K (2009) Air embolism and needle track implantation complicating CT-guided percutaneous thoracic biopsy: single-institution experience. Am J Roentgenol 193:W430–W436

    Article  Google Scholar 

  26. Kim JH, Kim YT, Lim HK, Kim YH, Sung SW (2003) Management for chest wall implantation of non-small cell lung cancer after fine-needle aspiration biopsy. Eur J Cardiothorac Surg 23:828–832

    Article  PubMed  Google Scholar 

Download references

Disclosures

Tetsuya Isaka, Ko Takahashi, Takamitsu Maehara, and Munetaka Masuda have no conflicts of interest to disclose.

Funding information

There is no source of fund.

Author information

Authors and Affiliations

  1. Department of Respiratory Surgery, Yokohama Rosai Hospital, 3211 Kodukue, Kohoku, Yokohama, Kanagawa, 222-0036, Japan

    Tetsuya Isaka, Ko Takahashi & Takamitsu Maehara

  2. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan

    Tetsuya Isaka & Munetaka Masuda

Authors
  1. Tetsuya Isaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ko Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takamitsu Maehara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Munetaka Masuda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tetsuya Isaka.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Isaka, T., Takahashi, K., Maehara, T. et al. Intraoperative core needle biopsy under complete video-assisted thoracic surgery for indeterminate tumor of lung. Surg Endosc 29, 3579–3587 (2015). https://doi.org/10.1007/s00464-015-4112-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-015-4112-2

Keywords

Search

Navigation