Needlescopic Resection of Small and Superficial Pulmonary Nodule After Computed Tomographic Fluoroscopy-Guided Dual Localization with Radiotracer and Hookwire

Kyung Won Doo, Hwan-Seok Yong, Hyun Koo Kim, Sungeun Kim, Eun-Young Kang, Young Ho Choi

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26 Citations (Scopus)

Abstract

Purpose: The aim of this study was to evaluate the feasibility of a needlescopic resection for small and superficial pulmonary nodules after dual localization with radiotracer and hookwire.

Results: The mean size of the nodules was 12.5 ± 5.4 mm (range 3–20), and their mean distance from the pleural surface was 5.6 ± 5.8 mm (range 0–18.7). The time of the dual localization procedure was 10.8 ± 3.6 min (range 5–18). Pneumothorax was developed in 6 of 34 patients (17.6 %) after preoperative localization, but did not require any treatment. Seven hookwires dislodged during the operation. Nevertheless, radiotracer markings detected on a gamma probe guided a successful wedge resection without difficulty in all seven cases. All nodules were successfully resected under needlescopy, except conversion to the 5-mm-sized thoracoscopy in four patients due to pleural adhesion.

Methods: Computed tomography (CT) fluoroscopy-guided dual marking with hookwire and <sup>99m</sup>Tc-phytate was performed on 36 small and superficial pulmonary nodules of 34 patients, just before the needlescopic procedure. This method was carried out through one introducer needle, after an initial single puncture. After detection of the hookwire-marked site through needlescopy, the precise lesion was confirmed using a thoracoscopic gamma probe by calculating the highest radioactivity. The pulmonary nodule was resected and diagnosed by pathologic examination.

Conclusions: Dual marking with radiotracer and hookwire under CT fluoroscopy is a safe and not time-consuming procedure, and has made needlescopy-assisted lung resection for small and superficial nodules or ground-glass opacity lesions easier, more convenient, and less hazardous.

Original languageEnglish
Pages (from-to)331-337
Number of pages7
JournalAnnals of Surgical Oncology
Volume22
Issue number1
DOIs
Publication statusPublished - 2014

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Fluoroscopy
Lung
Tomography
Thoracoscopy
Phytic Acid
Pneumothorax
Punctures
Radioactivity
Needles
Glass

ASJC Scopus subject areas

  • Surgery
  • Oncology
  • Medicine(all)

Cite this

@article{f7cb5ad7a18b424fbf69f55e61edafa2,
title = "Needlescopic Resection of Small and Superficial Pulmonary Nodule After Computed Tomographic Fluoroscopy-Guided Dual Localization with Radiotracer and Hookwire",
abstract = "Purpose: The aim of this study was to evaluate the feasibility of a needlescopic resection for small and superficial pulmonary nodules after dual localization with radiotracer and hookwire.Results: The mean size of the nodules was 12.5 ± 5.4 mm (range 3–20), and their mean distance from the pleural surface was 5.6 ± 5.8 mm (range 0–18.7). The time of the dual localization procedure was 10.8 ± 3.6 min (range 5–18). Pneumothorax was developed in 6 of 34 patients (17.6 {\%}) after preoperative localization, but did not require any treatment. Seven hookwires dislodged during the operation. Nevertheless, radiotracer markings detected on a gamma probe guided a successful wedge resection without difficulty in all seven cases. All nodules were successfully resected under needlescopy, except conversion to the 5-mm-sized thoracoscopy in four patients due to pleural adhesion.Methods: Computed tomography (CT) fluoroscopy-guided dual marking with hookwire and 99mTc-phytate was performed on 36 small and superficial pulmonary nodules of 34 patients, just before the needlescopic procedure. This method was carried out through one introducer needle, after an initial single puncture. After detection of the hookwire-marked site through needlescopy, the precise lesion was confirmed using a thoracoscopic gamma probe by calculating the highest radioactivity. The pulmonary nodule was resected and diagnosed by pathologic examination.Conclusions: Dual marking with radiotracer and hookwire under CT fluoroscopy is a safe and not time-consuming procedure, and has made needlescopy-assisted lung resection for small and superficial nodules or ground-glass opacity lesions easier, more convenient, and less hazardous.",
author = "Doo, {Kyung Won} and Hwan-Seok Yong and Kim, {Hyun Koo} and Sungeun Kim and Eun-Young Kang and Choi, {Young Ho}",
year = "2014",
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T1 - Needlescopic Resection of Small and Superficial Pulmonary Nodule After Computed Tomographic Fluoroscopy-Guided Dual Localization with Radiotracer and Hookwire

AU - Doo, Kyung Won

AU - Yong, Hwan-Seok

AU - Kim, Hyun Koo

AU - Kim, Sungeun

AU - Kang, Eun-Young

AU - Choi, Young Ho

PY - 2014

Y1 - 2014

N2 - Purpose: The aim of this study was to evaluate the feasibility of a needlescopic resection for small and superficial pulmonary nodules after dual localization with radiotracer and hookwire.Results: The mean size of the nodules was 12.5 ± 5.4 mm (range 3–20), and their mean distance from the pleural surface was 5.6 ± 5.8 mm (range 0–18.7). The time of the dual localization procedure was 10.8 ± 3.6 min (range 5–18). Pneumothorax was developed in 6 of 34 patients (17.6 %) after preoperative localization, but did not require any treatment. Seven hookwires dislodged during the operation. Nevertheless, radiotracer markings detected on a gamma probe guided a successful wedge resection without difficulty in all seven cases. All nodules were successfully resected under needlescopy, except conversion to the 5-mm-sized thoracoscopy in four patients due to pleural adhesion.Methods: Computed tomography (CT) fluoroscopy-guided dual marking with hookwire and 99mTc-phytate was performed on 36 small and superficial pulmonary nodules of 34 patients, just before the needlescopic procedure. This method was carried out through one introducer needle, after an initial single puncture. After detection of the hookwire-marked site through needlescopy, the precise lesion was confirmed using a thoracoscopic gamma probe by calculating the highest radioactivity. The pulmonary nodule was resected and diagnosed by pathologic examination.Conclusions: Dual marking with radiotracer and hookwire under CT fluoroscopy is a safe and not time-consuming procedure, and has made needlescopy-assisted lung resection for small and superficial nodules or ground-glass opacity lesions easier, more convenient, and less hazardous.

AB - Purpose: The aim of this study was to evaluate the feasibility of a needlescopic resection for small and superficial pulmonary nodules after dual localization with radiotracer and hookwire.Results: The mean size of the nodules was 12.5 ± 5.4 mm (range 3–20), and their mean distance from the pleural surface was 5.6 ± 5.8 mm (range 0–18.7). The time of the dual localization procedure was 10.8 ± 3.6 min (range 5–18). Pneumothorax was developed in 6 of 34 patients (17.6 %) after preoperative localization, but did not require any treatment. Seven hookwires dislodged during the operation. Nevertheless, radiotracer markings detected on a gamma probe guided a successful wedge resection without difficulty in all seven cases. All nodules were successfully resected under needlescopy, except conversion to the 5-mm-sized thoracoscopy in four patients due to pleural adhesion.Methods: Computed tomography (CT) fluoroscopy-guided dual marking with hookwire and 99mTc-phytate was performed on 36 small and superficial pulmonary nodules of 34 patients, just before the needlescopic procedure. This method was carried out through one introducer needle, after an initial single puncture. After detection of the hookwire-marked site through needlescopy, the precise lesion was confirmed using a thoracoscopic gamma probe by calculating the highest radioactivity. The pulmonary nodule was resected and diagnosed by pathologic examination.Conclusions: Dual marking with radiotracer and hookwire under CT fluoroscopy is a safe and not time-consuming procedure, and has made needlescopy-assisted lung resection for small and superficial nodules or ground-glass opacity lesions easier, more convenient, and less hazardous.

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