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Supplement CT-Guided Microcoil Placement for Localising Ground-glass Opacity (GGO) Lesions at “Blind Areas” of the Conventional Hook-Wire Technique - 27/09/17

Doi : 10.1016/j.hlc.2016.10.004 
Tao Zuo, MD a, 1, Shunbin Shi, MD b, 1, Long Wang, MD c, 1, Zhe Shi, MD c, Chenyang Dai, MD c, Chuanyi Li, MD c, Xiaogang Zhao, MD c, Zhengyi Ni, MD a, Ke Fei, MD c, Chang Chen, MD c,
a Department of Thoracic Surgery, Wuhan Medical Treatment Center, Shanghai, China 
b Department of Thoracic Surgery, First People's Hospital of Wujiang, Medical School of Nantong University, Shanghai, China 
c Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China 

Corresponding author at: Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. Tel.: +021-65115006

Resumen

Background

In the conventional hook-wire technique of pulmonary nodular localisations there are several “blind areas”, including the mediastinum-vicinity region, interlobar fissure-neighbouring areas and scapulae-shadowed areas. The present study aims to summarise the experiences of CT-guided microcoil placement as an alternative method for localising pulmonary ground-glass opacity (GGO) lesions before thoracoscopic wedge resections.

Methods

Sixteen GGO lesions at “blind areas” in 16 patients were localised with platinum-fibered microcoils under CT assistance before undergoing video-assisted thoracoscopic surgical resections. Information regarding coil placement, operations and complications was recorded.

Results

Of all lesions, 1 was in the mediastinum-vicinity region, 8 were covered by the scapulae, and 7 were close to interlobar fissures (3 horizontal fissures, 4 oblique fissures). All 16 (100%) lesions had been successfully marked with microcoils. No major complications of the puncture procedure occurred; there were only minor pneumothorax (n=2) and haemoptysis (n=1) complications, which required no intervention before operations. All GGO lesions and microcoils were successfully removed by initial wedge resections. Of the 16 lesions in “blind areas”, 8 were adenocarcinoma in situ (AIS), 4 were minimally invasive adenocarcinoma (MIA), 3 were atypical adenomatous hyperplasia (AAH), and 1 was interstitial fibrous tissue proliferation. No major complications occurred postoperatively.

Conclusions

For the “blind areas” of the hook-wire technique, CT-guided microcoil placement is an effective method of marking GGO lesions that makes thoracoscopic wedge resection easier.

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Keywords : Lung cancer surgery, Thoracoscopy/VATS


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© 2016  Publicado por Elsevier Masson SAS.
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Vol 26 - N° 7

P. 696-701 - juillet 2017 Regresar al número
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