Computed Tomography-Guided Wire-Marking for Thoracoscopic Resection of Small Lung Nodules in Children

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autor(en): Seitz ST, Schellerer V, Schmid A, Metzler M, Besendörfer M
Zeitschrift: Journal of Laparoendoscopic & Advanced Surgical Techniques
Jahr der Veröffentlichung: 2019
ISSN: 1092-6429


Abstract

Introduction: In pediatric patients, thoracoscopic wedge-resection of pulmonary nodules is an established therapy. However, intraoperative localization of small lesions is still challenging. Purpose of this study was to evaluate the efficacy of preoperative computed tomography (CT)-guided wire-marking of small lung nodules. Materials and Methods: Between 2012 and 2017 a total of six cases receiving thoracoscopic resection of CT-marked lung nodules were analyzed. The nodules were preoperatively tagged by a wire, which was attached to the thoracic wall by sterile dressing. Characteristics of interest were stability of wire, complete resection, and prevention of open thoracotomy. Results: Six procedures were performed on five patients, including four men and one woman. Median age at intervention was 16 years (range 11-19 years). All patients had a history of primary malignancies, including osteosarcoma (n = 4) and synovial sarcoma (n = 1). A total of 10 nodules were visualized in CT of which 9 were marked by wire. The median expected size of nodules was 6 mm (range 2-23 mm). Two patients had bilateral, two left-sided and two right-sided lung lesions. There was no wire slippage. In five procedures wedge resection was possible; one case needed a near total lobe resection. In one case a mini-thoracotomy at port insertion site was performed to extract the specimen. There was no conversion to thoracotomy. Histopathology showed R0 resection in all patients. Malignancy was found in all specimens. In one patient postoperative hemorrhagic anemia necessitated transfusion. Conclusions: Preoperative wire-localization of small lung nodules is a safe and effective tool to enable thoracoscopic resection in children and to avoid thoracotomic interventions.


FAU-Autoren / FAU-Herausgeber

Besendörfer, Manuel Dr. med.
Kinderchirurgische Abteilung in der Chirurgischen Klinik
Metzler, Markus PD Dr.
Professur für Kinder- und Jugendmedizin mit dem Schwerpunkt Pädiatrische Onkologie und Hämatologie
Schellerer, Vera PD Dr.
Kinderchirurgische Abteilung in der Chirurgischen Klinik
Schmid, Axel PD Dr.
Radiologisches Institut


Zitierweisen

APA:
Seitz, S.T., Schellerer, V., Schmid, A., Metzler, M., & Besendörfer, M. (2019). Computed Tomography-Guided Wire-Marking for Thoracoscopic Resection of Small Lung Nodules in Children. Journal of Laparoendoscopic & Advanced Surgical Techniques. https://dx.doi.org/10.1089/lap.2018.0184

MLA:
Seitz, Sigurd T., et al. "Computed Tomography-Guided Wire-Marking for Thoracoscopic Resection of Small Lung Nodules in Children." Journal of Laparoendoscopic & Advanced Surgical Techniques (2019).

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Zuletzt aktualisiert 2019-25-04 um 08:23