Original articleGeneral thoracicThoracoscopic Localization Techniques for Patients With Solitary Pulmonary Nodule and History of Malignancy
Section snippets
Material and Methods
Between January 2001 and December 2003, 50 patients with a history of malignancy and a pulmonary nodule underwent intrathoracoscopic localization at our institution. We selected all patients with solitary pulmonary nodule and positive history of malignancy. Because we work in a general surgery unit and in our hospital there is also a thoracic surgery unit, we therefore only see patients with a history of malignancy.
We excluded all patients with nodules larger than 1.5 cm or less than 2 cm deep.
Results
In group A, the intrathoracoscopic ultrasound localized the pulmonary nodule in 24 of 25 patients (96%) and finger palpation in 19 of 25 patients (76%; not significant); in group B, both radio-guided and finger palpation techniques localized the lesion in 20 of 25 patients (80%). Although no statistical significance could be demonstrated among different localization methods, the intrathoracoscopic ultrasound seems to be superior for detecting solitary pulmonary nodules as compared with both the
Comment
Preoperative localization techniques of pulmonary nodules have been extensively studied, and their pros and cons are well established. The needle-wire technique is associated with several complications [9, 10, 11], with dislodgment of the needle being the most important one. The latter generally occurs during transportation of the patient to the operating room or during the surgical procedure, either when the lung is deflated or during the resection of the nodule, as the surgeon will often
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