Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2022 Apr 20;20:eAO6665. doi: 10.31744/einstein_journal/2022AO6665. eCollection 2022.
To describe an experience in the preoperative localization of small pulmonary nodules and ground-glass lesions to guide minimally invasive thoracic surgery; in addition, a literature review was conducted, including the main advantages and disadvantages of the different agents used, and site marking in a hybrid operating room.
A retrospective search was conducted in a Interventional Radiology Department database, between March 2015 and May 2019, to identify patients undergoing preoperative percutaneous marking of lung injuries measuring up to 25mm.
A total of 20 patients were included and submitted to descriptive analysis. All patients were marked in a hybrid room, at the same surgical-anesthetic time. Most often used markers were guidewire, Lipiodol® and microcoils. Despite one case of coil displacement, two cases of pneumothorax, and one case of hypotension after marking, all lesions were identified and resected accordingly from all patients.
Preoperative percutaneous localization of lung injuries in hybrid room is an effective and a safe technique, which can have decisive impact on surgical resection. The choice of marker and of the operating room scenario should be based on availability and experience of service. Multidisciplinary discussions with surgical teams, pathologists, and interventional radiologists are crucial to improve outcome of patients.
描述一种在术前对小肺结节和磨玻璃病变进行定位以指导微创胸外科手术的经验；此外，还进行了文献复习，包括使用的不同药物的主要优缺点，以及在杂交手术室中的定位标记。
在 2015 年 3 月至 2019 年 5 月期间，在介入放射科数据库中进行了回顾性搜索，以确定接受术前经皮标记肺损伤（最大直径达 25mm）的患者。
共纳入 20 例患者进行描述性分析。所有患者均在杂交手术室中、同一手术-麻醉时间进行标记。最常使用的标记物是导丝、碘油和微线圈。尽管有 1 例线圈移位、2 例气胸和 1 例标记后低血压，但所有患者的所有病变均被识别并相应切除。
在杂交手术室中对肺损伤进行术前经皮定位是一种有效且安全的技术，对手术切除具有决定性影响。标记物和手术室场景的选择应基于服务的可用性和经验。与外科团队、病理学家和介入放射科医生进行多学科讨论对于改善患者的预后至关重要。
