Author of

• 12305

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  O25 - Stigma and Nihilism (ID 139)

  • Event: WCLC 2013
  • Type: Oral Abstract Session
  • Track: Nurses
  • Presentations: 1
  • Moderators:J.K. Cataldo, S. Sinclair
  • Coordinates: 10/29/2013, 16:15 - 17:45, Bayside Gallery B, Level 1

  • 12311

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    O25.06 - Electromagnetic Navigation Bronchoscopy directed pleural tattoo to aid surgical resection of Peripheral Pulmonary Lesion (ID 1738)

    17:05 - 17:15  |  Author(s): D. Steinfort
    • Abstract
    • Presentation
    • Slides

    Background
    Limited (wedge) resection of pulmonary lesions is frequently performed as a diagnostic/therapeutic procedure. Some lesions may be difficult to locate thoracoscopically and conversion to open thoracotomy or incomplete resection are potential limitations to this approach. Multiple methods have been described to aid Video-assisted thoracoscopic surgical (VATS) wedge resection of pulmonary nodules including hookwire localization, percutaneous tattoo or intra-operative ultrasound. We report on our experience using Electromagnetic Navigational (EMN) bronchoscopic dye marking of small subpleural lesions to assist wedge resection.

    Methods
    Six patients planned for VATS resection of a peripheral pulmonary lesion underwent pre-operative bronchoscopy. Electromagnetic navigation was utilized to accurately guide a 25-gauge needle to within/adjacent to the lesion for resection and 1mL of methylene blue or indigo carmine was injected under fluoroscopic vision.

    Results
    Six patients underwent bronchoscopic marking of peripheral pulmonary lesions. Navigation to lesions was successful in all six patients. Surgery was performed within 24 hours of bronchoscopic marking. Pleural staining by dye was visible thoracoscopically in all six lesions either adjacent to or overlying the lesion. All lesions were fully excised with wedge resection. Pathologic examination confirmed accuracy of dye staining and established the diagnosis of malignancy.

    Conclusion
    EMN bronchoscopic dye marking of peripheral lesions is feasible, and is not compromised by complications associated with percutaneous marking procedures. Further experience is required but early findings suggest this method may have utility in aiding minimally invasive resection of small subpleural lesions.

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