Abstract
to report the preoperative localization of pulmonary nodules with the placement of a guidewire oriented by Computed Tomography. the nodules were marked using a needle in the shape of a hook or another in the shape of a Q, guided by tomography. The choice of the location for the marking was the shortest distance from the chest wall to the nodule. The marking procedure was performed under local anesthesia and a tomographic control was obtained immediately at the end. Patients were referred to the operating room. Surgical resection occurred less than two hours after the needle placement. between February 2017 and October 2019, 22 patients aged 43 to 82 years (mean 62.1) were included. The nodules had diameters that varied from 4 to 30 mm and the distance between the nodules and the pleural surface varied from 2 to 43 mm. The location and resection of the nodules were successfully performed in all cases. The guidewire was displaced in five cases. Five patients presented pneumothorax, with the space between the visceral and parietal pleura varying from 2 to 19 mm. In nine patients, an intraparenchymal hematoma of 6 to 35 mm in length was observed without signs, symptoms, or hemodynamic and ventilatory repercussions. The histopathological study was conclusive in all patients. the localization of pulmonary nodules through guidewires proved to be safe, reliable, and feasible in this series of cases. There was no need for surgical intervention to treat complications.
Highlights
In the last three decades, minimally invasive surgery has been constantly and swiftly developing, greatly changing the surgeon’s routine
The incessant search for diagnostic techniques and more efficient and effective treatment, with fewer complications, lower response to trauma, and ever faster recovery time are the objectives of laparoscopic surgery, which allowed the best surgical results when compared with other techniques1
This article reports the experience in the marking of pulmonary nodules with the positioning of a guidewire oriented by Computed Tomography (CT)
Summary
In the last three decades, minimally invasive surgery has been constantly and swiftly developing, greatly changing the surgeon’s routine. The incessant search for diagnostic techniques and more efficient and effective treatment, with fewer complications, lower response to trauma, and ever faster recovery time are the objectives of laparoscopic surgery, which allowed the best surgical results when compared with other techniques. The incessant search for diagnostic techniques and more efficient and effective treatment, with fewer complications, lower response to trauma, and ever faster recovery time are the objectives of laparoscopic surgery, which allowed the best surgical results when compared with other techniques1 Thoracic surgery followed this process and today thoracoscopy is a routine procedure, in Brazil this is not the reality in most services. Nodules less than 10 mm in size located more than 10 mm from the pleural surface are a real challenge as for their perioperative locating4 In these cases, there is indication of perioperative marking. This article reports the experience in the marking of pulmonary nodules with the positioning of a guidewire oriented by Computed Tomography (CT)
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