A primary study of intraoperative ultrasound location of pulmonary ground-glass opacities in video-assisted thoracic surgery

Abstract

Objective To evaluate the clinical significance of video-assisted thoracic surgery (VATS) in localization of pulmonary ground-glass opacities(GGOs) by intraoperative ultrasound (IU). Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins. Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung. The sonographic characteristics of nodules were compared with those from CT and pathology. Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications.In all instances 13 GGOs were localized in the lung of complet collapse, and high-quality echo images were obtained. Additionally, the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens(P<0.05). There was significant difference in lung collapse degree, the maximum diameter of CT and the distance from the lesion to the pleura between echo types (P<0.05). The mean operation time was (4.2±2.7)min. Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung. Hence, ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO. Key words: Ultrasonography; Thoracoscopes; Ground-glass opacity