Lizza N, Eucher P, Haxhe J P, De Wispelaere J F, Johnson P M, Delaunois L
Department of Cardiovascular and Thoracic Surgery, University of Louvain Medical School at Mont-Godinne University Hospital, Yvoir, Belgium.
Ann Thorac Surg. 2001 Mar;71(3):986-8. doi: 10.1016/s0003-4975(00)02505-4.
A limiting factor in performing video-assisted thoracic surgery for resection of peripheral solitary pulmonary nodules has been the recognition of the lesion visually. This study reports our clinical experience of injecting a small metallic marker under computed tomographic scan guidance before the operation, allowing localization of the lesion.
A series of 14 patients underwent video-assisted thoracic surgery for removal of 15 pulmonary nodules situated in the outer third of the lung. Before operation, a radiopaque microcoil was injected just behind the lesion and then used to locate, under fluoroscopy, the area to be resected during thoracoscopy. The technique was evaluated for accuracy, reliability, and ease of use.
Microcoil labeling of peripheral pulmonary nodules allowed in every case a complete resection and a histologic identification of the lesion. It is more stable and accurate than methylene blue dye marking, and it is as easy to perform as computed tomographic scan-guided biopsy. The incidence of complication was small in spite of our inexperience with the technique.
Our experience with microcoil injection shows that it provides consistent and highly accurate marking of pulmonary nodules for video-assisted thoracic surgery, allowing secure resection with a safe margin.
在电视辅助胸腔镜手术切除周围型孤立性肺结节时，一个限制因素是通过视觉识别病变。本研究报告了我们在术前计算机断层扫描引导下注射小金属标记物以定位病变的临床经验。
14例患者接受电视辅助胸腔镜手术以切除位于肺外三分之一处的15个肺结节。术前，在病变后方注射不透射线的微线圈，然后在荧光透视下用于定位胸腔镜检查期间要切除的区域。对该技术的准确性、可靠性和易用性进行了评估。
外周肺结节的微线圈标记在每种情况下都能实现病变的完整切除和组织学鉴定。它比亚甲蓝染料标记更稳定、准确，并且与计算机断层扫描引导下活检一样易于操作。尽管我们对该技术缺乏经验，但并发症发生率较低。
我们注射微线圈的经验表明，它为电视辅助胸腔镜手术提供了一致且高度准确的肺结节标记，能够在安全切缘的情况下进行可靠切除。
