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Published in:

01-03-2007

Video-assisted Thoracoscopic Resection of a Small Pulmonary Nodule after Computed Tomography–guided Localization with a Hook-wire System

Experience in 45 Consecutive Patients

Authors: Olivier Pittet, MD, Michel Christodoulou, MD, Edgardo Pezzetta, MD, Sabine Schmidt, MD, Pierre Schnyder, MD, Hans-Beat Ris, MD

Published in: World Journal of Surgery | Issue 3/2007

Abstract

Background

This study is a single-institution validation of video-assisted thoracoscopic (VATS) resection of a small solitary pulmonary nodule (SPN) previously localized by a CT-guided hook-wire system in a consecutive series of 45 patients.

Methods

The records of all patients undergoing VATS resection for SPN preoperatively localized by CT-guided a hook-wire system from January 2002 to December 2004 were assessed with respect to failure to localize the lesion by the hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of SPN.

Results

Forty-five patients underwent 49 VATS resections, with simultaneous bilateral SPN resection performed in 4. Preoperative CT-guided hook-wire localization failed in two patients (4%). Conversion thoracotomy was necessary in two patients (4%) because it was not possible to resect the lesion by a VATS approach. The average operative time was 50 min. Postoperative complications occurred in 3 patients (6%), one hemothorax and two pneumonia. The mean hospital stay was 5 days (range: 2–18 days). Histological assessment revealed inflammatory disease in 17 patients (38%), metastasis in 17 (38%), non-small-cell lung cancer (NSCLC) in 4 (9%), lymphoma in 3 (6%), interstitial fibrosis in 2 (4%), histiocytoma in one (2%), and hamartoma in one (2%).

Conclusions

Histological analysis of resected SPN revealed unexpected malignant disease in more than 50% of the patients indicating that histological clarification of SPN seems warranted. Video-assisted thoracoscopic resection of SPN previously localized by a CT-guided hook-wire system is related to a low conversion thoracotomy rate, a short operation time, and few postoperative complications, and it is well suited for the clarification of SPN.

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Title: Video-assisted Thoracoscopic Resection of a Small Pulmonary Nodule after Computed Tomography–guided Localization with a Hook-wire System
Experience in 45 Consecutive Patients
Authors: Olivier Pittet, MD
Michel Christodoulou, MD
Edgardo Pezzetta, MD
Sabine Schmidt, MD
Pierre Schnyder, MD
Hans-Beat Ris, MD
Publication date: 01-03-2007
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 3/2007
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-006-0343-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Video-assisted Thoracoscopic Resection of a Small Pulmonary Nodule after Computed Tomography–guided Localization with a Hook-wire System

Experience in 45 Consecutive Patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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