Journal
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
Volume 34, Issue 1, Pages 91-98Publisher
OXFORD UNIV PRESS
DOI: 10.1093/icvts/ivab223
Keywords
Pulmonary nodules; Subsolid nodules; Radio-guided; Preoperative localization; I-125 seeds; Video-assisted thoracic surgery; Computed tomography
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CT-guided preoperative localization of pulmonary nodules by percutaneous marking with radio-labelled iodine-125 seeds is a feasible and safe technique, with a high success rate of resection and low incidence of complications.
OBJECTIVES: Videothoracoscopic visualization and/or palpation of pulmonary nodules may be difficult due to their location, small size or limited solid component. The purpose of this study is to present our experience with computed tomography (CT)-guided preoperative localization of pulmonary nodules by percutaneous marking with radio-labelled iodine-125 seeds. METHODS: A total of 34 pulmonary nodules were marked under CT with the placement of 33 radio-labelled iodine-125 seeds in 32 consecutive patients. RESULTS: All patients underwent biportal video-assisted thoracic surgery (VATS) and in no case was conversion to thoracotomy necessary. A total of 88.2% of the lung nodules were successfully resected. In the remaining 11.8%, migration of the seed to the pleural cavity occurred, although these nodules were still resected during VATS. Of all the patients with pneumothorax after the marking procedure, only one required chest tube placement (3.1%). No major postoperative complications were observed. CONCLUSIONS: Preoperative marking of pulmonary nodules with I-125 seeds under CT guidance is a feasible and safe technique that allows their intraoperative identification and resection.
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