scholarly journals Intraoperative Lung Ultrasound (ILU) for the Assessment of Pulmonary Nodules

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1691
Author(s):  
Marco Taurchini ◽  
Carla Maria Irene Quarato ◽  
Elisabetta Maria Frongillo ◽  
Gian Maria Ferretti ◽  
Cristiana Cipriani ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Thoracoscopic Surgery ◽  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Open Thoracotomy ◽  
Digital Palpation ◽  
Malignant Lesions ◽  
Transthoracic Ultrasound ◽  
Video Assisted Thoracoscopic Surgery ◽  
Morphological Patterns

Background: The primary aim of this study was to confirm the validity of intraoperative lung ultrasound (ILU) as a safe and effective method of localization for difficult to visualize pulmonary nodules during Video-Assisted Thoracoscopic Surgery (VATS) and open thoracotomy. The secondary aim was to enhance knowledge on the morphological patterns of presentation of pulmonary nodules on direct ultrasound examination. Materials and methods: 131 patients with lung nodule and indication for surgery were enrolled. All patients underwent pre-operative imaging of the chest, including Chest Computed Tomography (CT) and Transthoracic Ultrasound (TUS), and surgical procedures for histological assessment of pulmonary nodules (VATS or open thoracotomy). Results: The identification of 100.00% of lung nodules was allowed by ILU, while the detection rate of digital palpation was 94.66%. It was not possible to associate any specific ILU echostructural pattern to both benign or malignant lesions. However, the actual histological margins of the lesions in the operating samples were corresponding to those visualized at ILU in 125/131 (95.42%) cases. No complications have been reported with ILU employment. Conclusions: In our experience, ILU performed during both open surgery and VATS demonstrated to be a reliable and safe method for visualization and localization of pulmonary nodules non previously assessed on digital palpation. In addition, ILU showed to allow a clear nodule’s margins’ definition matching, in most cases, with the actual histological margins.

Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection

2021 ◽  
Author(s):  
Carlos Carvajal ◽  
Felipe González ◽  
Rafael Beltrán ◽  
Ricardo Buitrago ◽  
Amelia de los Reyes ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Nodule ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery ◽  
Surgery Resection

Video-Assisted Thoracoscopic Surgery for Small Indeterminate Pulmonary Nodules

CHEST Journal ◽  
1999 ◽  
Vol 115 (2) ◽  
pp. 563-568 ◽  
Author(s):  
Kenji Suzuki ◽  
Kanji Nagai ◽  
Junji Yoshida ◽  
Hironobu Ohmatsu ◽  
Kenro Takahashi ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals CT-Guided Hook-Wire Localization of Malignant Pulmonary Nodules for Video Assisted Thoracoscopic Surgery

2020 ◽  
Author(s):  
Huijun Zhang ◽  
Ying Li ◽  
Nadier Yimin ◽  
Zelai He ◽  
Xiaofeng Chen
Keyword(s):  
Thoracoscopic Surgery ◽  
Small Diameter ◽  
Pulmonary Nodules ◽  
Lung Parenchyma ◽  
Preoperative Localization ◽  
Wire Localization ◽  
Ct Guided ◽  
Video Assisted ◽  
Hook Wire ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objectives: Video assisted thoracoscopic surgery (VATS) can currently be used to diagnose and treat pulmonary nodules. However, intraoperative location of pulmonary nodules in VATS is challenging due to their small diameter and deep location in the pulmonary parenchyma. The purpose of this study was to report the clinical safety and effectiveness of CT-guided hook-wire for preoperative localization of malignant pulmonary nodules smaller than 1 cm in diameter.Methods: From February 2017 to January 2018, we collected the data of 80 patients with malignant pulmonary nodules less than 1 cm in diameter who underwent CT-guided hook-wire preoperative localization and VATS surgery. The effectiveness of preoperative localization was evaluated based on surgical duration, success rate of VATS surgery, and localization-related complications.Results: The diameter of pulmonary nodules were 0.85 ± 0.17 mm with a distance to the pleural surface of 19.66 ± 14.10 mm. The length of the hook-wire in the lung parenchyma was 29.17 ± 13.14 mm and hook-wire dislodgement occurred in 2 patients. Complications included 27 cases of minor pneumothorax and 18 cases of mild parenchymal hemorrhage. A significant correlation was observed between the length of the hook-wire in the lung parenchyma and mild parenchymal hemorrhage (P = 0.044). The average time of hook-wire localization was 9.0 ± 2.6 min and the average operation time for VATS was 89.02 ± 23.35 min without conversion thoracotomy.Conclusions: CT-guided hook-wire localization of the lesion during VATS resection is safe for malignant pulmonary nodules with diameter less than 1 cm.

Analysis of conversion to thoracotomy during thoracoscopic lung resection

2019 ◽  
Vol 27 (5) ◽  
pp. 381-387 ◽  
Author(s):  
Katsunari Matsuoka ◽  
Tetsu Yamada ◽  
Takahisa Matsuoka ◽  
Shinjiro Nagai ◽  
Mitsuhiro Ueda ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Thoracoscopic Surgery ◽  
Clinical Stage ◽  
Lung Resection ◽  
Open Thoracotomy ◽  
Advanced Clinical Stage ◽  
Video Assisted ◽  
Surgery Group ◽  
Intraoperative Conversion ◽  
Video Assisted Thoracoscopic Surgery

Background Video-assisted thoracoscopic surgery has been widely adopted. However, conversion to open thoracotomy is still necessary when intraoperative complications are encountered. Methods Between January 2009 and December 2014, 1566 patients underwent anatomical lung resection for lung cancer using video-assisted thoracoscopic surgery at our institution. Among these patients, 39 required conversion to open thoracotomy. We retrospectively examined the current status of conversion to thoracotomy during video-assisted thoracoscopic surgery in a single city hospital. Data were compared with those of 89 patients undergoing a scheduled thoracotomy. Results The main reason for conversion was the need for angioplasty for pulmonary artery invasion by silicotic lymph nodes (12 cases), and metastatic lymph nodes or tumors (9 cases). Univariate analysis demonstrated that the risk factors for conversion were male sex, smoking habit, induction therapy, large tumor size, and advanced stage. Multivariate analysis showed that advanced clinical stage was the only significant predictor of intraoperative conversion. Compared to the video-assisted thoracoscopic surgery group, mortality and morbidity in the conversion group were significantly higher, but there was no significant difference in mortality or morbidity between the conversion and scheduled thoracotomy groups. The conversion group showed a significantly higher rate of lethal acute exacerbation of interstitial pneumonitis than the video-assisted thoracoscopic surgery group. Conclusion The main reason for conversion was angioplasty, and advanced clinical stage was a significant predictor of intraoperative conversion. Conversion was safely performed but postoperative complications, although similar in frequency to scheduled thoracotomy cases, were more frequent than those in thoracoscopic surgery cases.

scholarly journals Ultrasound location of pulmonary nodules in video‐assisted thoracoscopic surgery for precise sublobectomy

2020 ◽  
Vol 11 (5) ◽  
pp. 1354-1360
Author(s):  
Yue‐Long Hou ◽  
Yan‐Dong Wang ◽  
Hong‐Qi Guo ◽  
YuKun Zhang ◽  
YongKuan Guo ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Characteristics of benign solitary pulmonary nodules confirmed by diagnostic video-assisted thoracoscopic surgery

2014 ◽  
Vol 10 (2) ◽  
pp. 181-188 ◽  
Author(s):  
Sun Mi Choi ◽  
Eun Young Heo ◽  
Jinwoo Lee ◽  
Young Sik Park ◽  
Chang-Hoon Lee ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Fibrinolíticos no Tratamento de Derrames Pleurais Complicados

2016 ◽  
Vol 29 (11) ◽  
pp. 711 ◽  
Author(s):  
Ana Coelho ◽  
Margarida Coelho ◽  
Joana Pereira ◽  
Vasco Lavrador ◽  
Lurdes Morais ◽  
...  
Keyword(s):  
Failure Rate ◽  
Thoracoscopic Surgery ◽  
Therapeutic Option ◽  
Fibrinolytic Therapy ◽  
Chest Drain ◽  
Open Thoracotomy ◽  
Effective Treatment Option ◽  
Therapeutic Success ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Introduction: The treatment of complicated pleural parapneumonic effusions with intrapleural instillation of fibrinolytics, has shown similar results as surgical treatment. The present study aimed to evaluate the results of the use of intrapleural instillation of fibrinolytics in the treatment of complicated pleural parapneumonic effusions, in patients followed in our hospital.Material and Methods: A retrospective review of all the patients (aged between one month and 18 years) diagnosed with complicated parapneumonic effusions, which had chest drain insertion with intrapleural instillation of fibrinolytic, between January 2005 andDecember 2013, was undertaken.Results: A total of 37 patients were identified. Mean duration of hospital stay was 17 ± 7.60 days. Chest drain was placed in the first 48 h of hospital admission in most of the patients (89.2%), with a mean of six days of drainage. Treatment failure was reported in 2.7% of cases and was related with effusion recurrence. This patient underwent video-assisted thoracoscopic surgery with the need to convert to open thoracotomy. A favorable outcome was achieved in 96.9 % of cases.Discussion: In our review, therapeutic success rate was as expected, with a failure rate below those reported in literature. We present intrapleural instillation of fibrinolytics and video-assisted thoracoscopic surgery as part of the same protocol, in which fibrinolytic therapy is the first-line treatment.Conclusion: The therapeutic option presented shows a low failure rate and avoids a more aggressive surgical procedure. We consider this an effective treatment option, with low sequelae rate.

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