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Computed tomography-guided microcoil placement for localizing small pulmonary nodules before uniportal video-assisted thoracoscopic resection

  • Chest Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The increasing number of computed tomography (CT) performed allows the more frequent identification of small, solid pulmonary nodules or ground-glass opacities. Video-assisted thoracic surgery (VATS) represents the standard in most lung resections. However, since VATS limit is the digital palpation of the lung parenchyma, many techniques of nodule localization were developed. The aim of this study was to determine the feasibility and safety of CT-guided microcoil insertion followed by uniportal VATS wedge resection (WR).

Materials and methods

Retrospective study in a single institution, including patients undergone CT-guided microcoil insertion prior to uniportal VATS resection between May 2015 and December 2018. The lesion was identified using fluoroscopy.

Results

Forty-six consecutive patients were enrolled (22 male and 24 female). On CT: 5 cases of GGO, 2 cases of semisolid nodules, 39 cases of solid nodules. The median pathologic tumor size was 1.21 cm. Neither conversion to thoracotomy nor microcoil dislodgement was recorded. All patients underwent uniportal VATS WR (9/46 underwent completion lobectomy after frozen section). WR median time was 105 min (range 50–150 min). No patients required intraoperative re-resection for positive margins. After radiological procedure, 1 case of hematoma and 2 cases of pneumothorax were recorded. Four complications occurred in the postoperative period. The mean duration of chest drain and length of stay were 2.9 and 4.6 days, respectively.

Conclusions

CT-guided microcoil insertion followed by uniportal VATS resection was a safe and feasible procedure having a minimal associated complications rate and offering surgeons the ease of localization of small intrapulmonary nodules.

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Authors and Affiliations

  1. Unit of Thoracic Surgery, AOU Ospedali Riuniti of Ancona, Ancona, Italy

    Majed Refai, Marco Andolfi, Alberto Roncon, Gian Marco Guiducci, Francesco Xiumè, Michele Salati & Michela Tiberi

  2. Unit of Anatomical Pathology, AOU Ospedali Riuniti of Ancona, Ancona, Italy

    Francesca Barbisan

  3. Department of Radiological Sciences, Polytechnic University of Marche, AOU Ospedali Riuniti of Ancona, Ancona, Italy

    Andrea Giovagnoni

  4. Unit of Interventional Radiology, AOU Ospedali Riuniti of Ancona, Ancona, Italy

    Enrico Paci

Authors
  1. Majed Refai
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  2. Marco Andolfi
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  3. Francesca Barbisan
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  4. Alberto Roncon
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  7. Michele Salati
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Corresponding author

Correspondence to Majed Refai.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was conducted on already available data and ethical approval was not required dependent on the law and the national ethical guidelines of the country. However, authors have checked with their institution to comply with the specific requirements of their country.

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Informed consent was obtained from all individual participants included in the study.

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Supplementary Video 1 Radiological and Surgical procedure. (MP4 89271 kb)

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Refai, M., Andolfi, M., Barbisan, F. et al. Computed tomography-guided microcoil placement for localizing small pulmonary nodules before uniportal video-assisted thoracoscopic resection. Radiol med 125, 24–30 (2020). https://doi.org/10.1007/s11547-019-01077-x

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  • DOI: https://doi.org/10.1007/s11547-019-01077-x

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