Denbratt L, Svanvik J, Rådberg G
Department of Radiology, Sahlgrenska Hospital, Gothenburg, Sweden.
Acta Radiol. 1996 Mar;37(2):234-6. doi: 10.1177/02841851960371P148.
Small pulmonary subpleural nodules are sometimes difficult to localise at thoracotomy. With the advent of minimal invasive surgery, thoracoscopic resection avoiding anterolateral thoracotomy is an attractive procedure. Since this technique does not allow manual palpation, preoperative indication of lesions is mandatory. A simple and cost-effective system for preoperative CT-guided localisation of small subpleural nodules before thoracoscopic resection is described.
The system consists of a 0.2 mm steel wire 30-40 cm in length and a 0.9-mm biopsy needle. The tip of the wire is bent to a hook, and, guided by CT, it is placed in the vicinity of the lesion. The technique was tested in 8 cases.
The procedure was possible to perform in 7 patients. In all instances the wire remained in place when the lung was collapsed during the thoracoscopic procedure. The staple resected part of the lung also contained the lesion when examined extracorporeally.
This simple and inexpensive system was found to be useful for indication of pulmonary lesions at thoracoscopic wedge resections.
小的肺胸膜下结节有时在开胸手术中难以定位。随着微创手术的出现，避免前外侧开胸的胸腔镜切除术是一种有吸引力的手术方法。由于该技术不允许手动触诊，术前明确病变位置至关重要。本文介绍一种简单且经济高效的系统，用于在胸腔镜切除术前对小的胸膜下结节进行CT引导下的定位。
该系统由一根长度为30 - 40厘米的0.2毫米钢丝和一根0.9毫米活检针组成。钢丝末端弯成钩状，在CT引导下放置在病变附近。该技术在8例患者中进行了测试。
7例患者成功完成手术。在所有病例中，胸腔镜手术期间肺萎陷时钢丝均保留在原位。体外检查时，肺的吻合器切除部分也包含病变。
这种简单且廉价的系统被发现可用于胸腔镜楔形切除术中肺病变的定位。
