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Computed tomography-guided patent blue vital dye localization of pulmonary nodules in uniportal thoracoscopy.
J Thorac Cardiovasc Surg. 2016 08; 152(2):535-544.e2.JT

Abstract

OBJECTIVE

Due to the limitations of the small single incision, an ideal preoperative localization technique is essential for surgical resection of small pulmonary nodules by uniportal video-assisted thoracoscopic surgery (VATS). The aim of this study is to evaluate the usefulness and safety of preoperative computed tomography (CT)-guided patent blue vital (PBV) dye localization in patients with small indeterminate pulmonary nodules who have undergone uniportal VATS for lung resection.

METHODS

In this retrospective study, 177 consecutive patients (196 pulmonary nodules) who underwent preoperative CT-guided PBV dye localization and uniportal VATS from January 2013 to September 2015 were enrolled.

RESULTS

The CT-dye localization procedure was performed successfully and correctly for 99.5% (195/196) of the nodules within a mean procedure time of 30 minutes. The mean size of the nodules was 7.8 mm, and their mean depth from the pleural surface was 18.3 mm. Most of the nodules (78.6%, 154/196) were pure ground-glass nodules (GGNs) and part-solid GGN with ground-glass opacity (GGO) of 50% or more. Asymptomatic pneumothorax occurred in 29.4% (52/177) of patients after the localization procedure, but none required invasive treatment. All nodules were successfully resected using uniportal VATS without any conversion to thoracotomy. The postoperative course was smooth, with a short mean hospital stay (3.3 ± 1.2 days) and a low morbidity rate (0.6%, 1/177).

CONCLUSIONS

Preoperative CT-guided PBV dye localization is a feasible, safe, and accurate procedure. It makes uniportal VATS easy for small, poorly located pulmonary nodules with GGO predominance and synchronous multiple nodules.

Authors+Show Affiliations

Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: ntuhsu@gmail.com.Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: ycc5566@ntu.edu.tw.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't
Video-Audio Media

Language

eng

PubMed ID

27189890

Citation

Lin, Mong-Wei, et al. "Computed Tomography-guided Patent Blue Vital Dye Localization of Pulmonary Nodules in Uniportal Thoracoscopy." The Journal of Thoracic and Cardiovascular Surgery, vol. 152, no. 2, 2016, pp. 535-544.e2.
Lin MW, Tseng YH, Lee YF, et al. Computed tomography-guided patent blue vital dye localization of pulmonary nodules in uniportal thoracoscopy. J Thorac Cardiovasc Surg. 2016;152(2):535-544.e2.
Lin, M. W., Tseng, Y. H., Lee, Y. F., Hsieh, M. S., Ko, W. C., Chen, J. Y., Hsu, H. H., Chang, Y. C., & Chen, J. S. (2016). Computed tomography-guided patent blue vital dye localization of pulmonary nodules in uniportal thoracoscopy. The Journal of Thoracic and Cardiovascular Surgery, 152(2), 535-e2. https://doi.org/10.1016/j.jtcvs.2016.04.052
Lin MW, et al. Computed Tomography-guided Patent Blue Vital Dye Localization of Pulmonary Nodules in Uniportal Thoracoscopy. J Thorac Cardiovasc Surg. 2016;152(2):535-544.e2. PubMed PMID: 27189890.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Computed tomography-guided patent blue vital dye localization of pulmonary nodules in uniportal thoracoscopy. AU - Lin,Mong-Wei, AU - Tseng,Yao-Hui, AU - Lee,Yee-Fan, AU - Hsieh,Min-Shu, AU - Ko,Wei-Chun, AU - Chen,Jo-Yu, AU - Hsu,Hsao-Hsun, AU - Chang,Yeun-Chung, AU - Chen,Jin-Shing, Y1 - 2016/04/25/ PY - 2016/02/01/received PY - 2016/03/26/revised PY - 2016/04/16/accepted PY - 2016/5/19/entrez PY - 2016/5/18/pubmed PY - 2018/7/31/medline KW - computed tomography-guided localization KW - lung tumor KW - patent blue vital dye KW - uniportal surgery KW - video-assisted thoracoscopic surgery SP - 535 EP - 544.e2 JF - The Journal of thoracic and cardiovascular surgery JO - J. Thorac. Cardiovasc. Surg. VL - 152 IS - 2 N2 - OBJECTIVE: Due to the limitations of the small single incision, an ideal preoperative localization technique is essential for surgical resection of small pulmonary nodules by uniportal video-assisted thoracoscopic surgery (VATS). The aim of this study is to evaluate the usefulness and safety of preoperative computed tomography (CT)-guided patent blue vital (PBV) dye localization in patients with small indeterminate pulmonary nodules who have undergone uniportal VATS for lung resection. METHODS: In this retrospective study, 177 consecutive patients (196 pulmonary nodules) who underwent preoperative CT-guided PBV dye localization and uniportal VATS from January 2013 to September 2015 were enrolled. RESULTS: The CT-dye localization procedure was performed successfully and correctly for 99.5% (195/196) of the nodules within a mean procedure time of 30 minutes. The mean size of the nodules was 7.8 mm, and their mean depth from the pleural surface was 18.3 mm. Most of the nodules (78.6%, 154/196) were pure ground-glass nodules (GGNs) and part-solid GGN with ground-glass opacity (GGO) of 50% or more. Asymptomatic pneumothorax occurred in 29.4% (52/177) of patients after the localization procedure, but none required invasive treatment. All nodules were successfully resected using uniportal VATS without any conversion to thoracotomy. The postoperative course was smooth, with a short mean hospital stay (3.3 ± 1.2 days) and a low morbidity rate (0.6%, 1/177). CONCLUSIONS: Preoperative CT-guided PBV dye localization is a feasible, safe, and accurate procedure. It makes uniportal VATS easy for small, poorly located pulmonary nodules with GGO predominance and synchronous multiple nodules. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/27189890/Computed_tomography_guided_patent_blue_vital_dye_localization_of_pulmonary_nodules_in_uniportal_thoracoscopy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(16)30254-9 DB - PRIME DP - Unbound Medicine ER -