Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12530

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    P3.07-035 - Benefit of preoperative localization using fragmented platinum microcoil for fluoroscopy-aided thoracoscopic resection of solitary pulmonary nodules (ID 2738)

    09:30 - 09:30  |  Author(s): Y.J. Chang
    • Abstract

    Background
    Preoperative localization is necessary to perform thoracoscopic resection of small or deeply located solitary pulmonary nodules (SPNs). We recently developed a new localization technique using a self-made, fragmented platinum microcoil, and retrospectively compared the effectiveness of our technique with that of lipiodol.

    Methods
    Fifty two patients underwent thoracoscopic pulmonary wedge resections for 57 SPNs between January 2006 and June 2013. Self-made, fragmented platinum microcoils (Easimarker) were targeted to localize 30 SPNs [17 solid nodules, and 13 ground glass opacities (GGOs)] in 28 patients (Group A), and lipiodol was injected in 27 SPNs (17 solid nodules, and 10 GGOs) of 22 patients (Group B). Preoperative localization using both targeting materials was performed into, or just around the pulmonary lesions on the day of thoracoscopic surgery in the room of chest CT scanner. Localized SPNs were then, wedgely resected using fluoroscopy-aided thoracoscopic surgery (FATS). The intraoperative fluoroscopic exposure (radiation) time, diagnostically detecting rate of pathologic lesions, and other clinical data were collected.

    Results
    Mean size and depth of SPNs in group A and B were 10.6 ± 4.7 mm (range: 0.9 to 23) versus 7.9 ± 4.9 mm (1 to 21), and 10.9 ± 7.9 mm (1 to 30) versus 9.7 ± 8.4mm (1 to 28.2), respectively. CT-guided localizations were successfully performed in both groups. No mortality and major morbidity were observed in both groups. All lesions in both groups were completely resected and diagnosed histopathologically. The intraoperative fluoroscopic exposure time of group A (55.0±40.8 seconds) was significantly shorter than that of group B (105.7±109.0 seconds).

    Conclusion
    Our preoperative localization procedure using fragmented platinum microcoils appears to be effective and feasible in that it has shorter intraoperative time, less radiation exposure, and better accuracy of detecting SPNs. Once inserted fragmented microcoil into the pulmonary lesions stays firmly and more visible radiologically, through lipiodol tends to diperse outside the targeting lesion.