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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2006 June;47(3):355-9

lingua: Inglese

Thoracoscopic localization techniques for patients with solitary pulmonary nodule: radioguided surgery versus hookwire localization

Davini F. 1, Gonfiotti A. 1, Vaggelli L. 2, De Francisci A. 3, Gigli P. 1, Janni A. 1

1 Thoracic Surgery Unit Careggi Hospital, Florence, Italy
2 Nuclear Medicine II Unit Careggi Hospital, Florence, Italy
3 Radiological Diagnostics II Unit Careggi Hospital, Florence, Italy


Aim. The aim of this study is to compare 2 different methods for localization of peripheral pulmonary lesions requiring thoracoscopic resection: radioguided surgery (still considered an innovative method) and computed tomography-guided hookwire localization.
Methods. Thirty randomized patients (21 males and 9 females), ranging from 21-74 years, average age 56.3 years) with solitary pulmonary nodule (SPN) were enrolled in this prospective study. Inclusion criteria was: a maximum nodule diameter of less than 3 cm and a maximum distance from the visceral pleura of 3 cm. The patients were subdivided into 2 equal groups and one of the 2 different methods for diagnosing SPN was applied. Group A received a thoracoscopy using the scinti-probe technique and group B received a thoracoscopy aided by a hooked needle.
Results. The frozen section revealed a primitive pulmonary tumor in 13 cases, intestinal adenocarcinoma metastasis in 3 cases and renal cancer metastasis in 1 case. The remaining 13 cases were pathologically benign: sarcoidosis in 6 cases, hamartochondroma in 3 cases, scleroanthracosis in 2 cases and tuberculoma in 2 cases.
Conclusion. On the basis of our experience, the conslusion is drawn that this methods has been proven efficacious in the diagnosis of SPN, and video-assisted thoracoscopy allows for the removal of pulmonary nodules without complications.

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