HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alessandro Gonfiotti Federico Davini Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gonfiotti, A. Articles by Janni, A. Search for Related Content PubMed PubMed Citation Articles by Gonfiotti, A. Articles by Janni, A. Related Collections Lung - cancer

Thoracoscopic localization techniques for patients with solitary pulmonary nodule: hookwire versus radio-guided surgery

^a Thoracic Surgery Unit, University Hospital Careggi, Florence, Italy
^b Division of Nuclear Medicine, University Hospital Careggi, Florence, Italy
^c Department of Radiology, University Hospital Careggi, Florence, Italy
^d Department of Human Pathology and Oncology, University Hospital Careggi, Florence, Italy

Received 17 May 2007; received in revised form 28 August 2007; accepted 3 September 2007.

^_* Corresponding author. Address: Thoracic Surgery Unit, University Hospital Careggi, Viale Pieraccini 17, Firenze 50100, Italy. Tel.: +39 055 7947935; fax: +39 055 7947935. (Email: agonfiotti{at}hotmail.com).

Objective: Our aim was to evaluate the best intrathoracoscopic localization technique between hookwire and radio-guided surgery, in patients with pulmonary nodule. Methods: From January 2000 to January 2005 we enrolled in this study 50 patients with a solitary pulmonary nodule, prospective randomized in two groups, well matched for diameter and depth of the pulmonary lesion. In 25 patients we performed the hookwire technique (Group A), whereas in the other 25 patients radio-guided localization was adopted (Group B). In both groups the localization technique was compared with finger palpation. In Group A, 9 lesions were in the left and 16 in the right lung; in Group B, 14 nodules were in the left lung and 11 in the right one. In both groups, the distance of the nodule from the pleural surface with lung inflated was 2.5 cm (1.5–2.5 cm in 12 patients, and >2.5 cm for the remaining 13). The mean size of the nodules in both groups was 1.1, range 0.6–1.9 (1 cm n = 18 patients, and >1 cm n = 7 patients). Results: All patients underwent thoracoscopic wedge resection, and 23 patients with a primary pulmonary lesion underwent thoracotomy for lobectomy and radical mediastinal lymphadenectomy. In Group A the hookwire technique localized the nodule in 21 of 25 patients (84%) whereas finger palpation localized it in 7 of 25 patients (28%). In Group B, radio-guided surgery localized the nodule in 24 of 25 patients (96%) whereas finger palpation localized it in 6 of 25 (24%). In Group A we registered 6 cases of pneumothorax compared to 1 case observed in the radio-guided group. Postoperative hospital stay required an average of 4 days in both groups. Conclusions: In our experience radio-guided surgery has therefore been proven efficacious in the diagnosis of solitary pulmonary nodule and video-assisted thoracoscopic surgery allows the removal of pulmonary nodules without complications. Hookwire was also shown to be efficacious but demonstrated complications linked primarily to external technical factors.

Key Words: Video-assisted thoracoscopic surgery • Solitary pulmonary nodule • Hookwire • Radio-guided surgery

This article has been cited by other articles:

				E. L. Grogan, G. J. Stukenborg, A. S. Nagji, W. Simmons, B. D. Kozower, D. R. Jones, and T. M. Daniel Radiotracer-Guided Thoracoscopic Resection is a Cost-Effective Technique for the Evaluation of Subcentimeter Pulmonary Nodules Ann. Thorac. Surg., September 1, 2008; 86(3): 934 - 940. [Abstract] [Full Text] [PDF]