Korean J Thorac Cardiovasc Surg.  2003 Oct;36(10):748-753.

New Paradigm for Patients with Pulmonary Nodule Expecting Thoracoscopic Resection

• Jo MS
• Moon SW
• Sim SB
• Wang YP
• Jo KH
• Suh JH
• Kwack MS
• Lee SH
• Kim HH
• Kim YK

Abstract

BACKGROUND: The pulmonary nodules (PN), when indicated, need thoracoscopic resection, especially in cases of non-diagnostic or technically infeasible PCNA (percutaneous needle aspiration). In the difficult situations of small or deeply seated PN, several techniques facilitating thoracoscopy have been used for detecting them. Our new protocol for managing PN was developed and prospectively reviewed. MATERIAL AND METHOD: In the procedure of PCNA, we firstly placed the tip of the needle in the center of, or just in contact with PN under CT guidance, and loaded one or two segments of platinum radiomarker inside the needle after removing the stylet. Then, we forced the radiomarker to move to the tip of the needle by pushing the stylet. Finally, if the tip of the needle was not within PN, it was reoriented to the their center to obtain the sample for PCNA. RESULT: Between May 1999 and May 2000, radiomarkers were successfully placed in 28 PN of 26 patients, with the exception of one. In 18 (85%) of 21 nodules needing throacoscopy, intraoperative fluoroscopy was used to detect them or guide stapling resection during thoracoscopy.
CONCLUSION
The advantages of this technique are that there is that there is no need for further localization for thoracoscopy even in cases of unsuccessful PCNA, and it was more effective in respect to both cost and time. Therefore, this strategy for PN expecting thoracoscopy will be helpful to patients and medical staff alike.

Keyword

Pulmonary nodule; Thoracoscopy; Percutaneous needle aspiration; Radiation marker

MeSH Terms

Fluoroscopy
Humans
Medical Staff
Needles
Platinum
Proliferating Cell Nuclear Antigen
Prospective Studies
Thoracoscopy
Platinum
Proliferating Cell Nuclear Antigen