Thoracoscopic Lung Resection for Extremely Small Nodular Lesions Using Simultaneous Intraoperative Real-Time Computed Tomography

Because the localization of small lung nodules at thoracoscopic resection is sometimes difficult, we have employed intraoperative real-time computed tomography (CT). Two patients with lung nodules less than 1 cm in diameter were treated using this technique. Detection of the lesion using CT and thoracoscopic resection is performed simultaneously in the interventional radiological CT examination room. After induction of general anesthesia with one-lung ventilation, the patient is placed in the lateral position. The lung nodule is detected using real-time CT and grasped with forceps. Thoracoscopic resection of the nodule is performed in the usual fashion. Frozen section examination is immediatley performed to decide on furhter therapy.

Key words:

Thoracoscopy - Lung resection - Real-time computed tomography - Lung cancer

References

• 1 Gossot D, Miaux Y, Guermazi A, Celerier M, Frija J. The hook-wire technique for localization of pulmonary nodules during thoracoscopic resection.  Chest.. 1994;  105 1467-9
• 2 Nomori H, Horio H. Colored collagen is a long-lasting point marker for small pulmonary nodules in thoracoscopic operations.  Ann Thorac Surg.. 1996;  61 1070-3
• 3 Wicky S, Mayor B, Duttat J F, Schnyder P. CT-guided locarizations of pulmonary nodules with methylene blue injections for thoracoscopic resections.  Chest.. 1994;  106 1326-8
• 4 Katada K, Kato R, Anno H. et al . Guidance with real-time CT fluoroscopy; early clinical experience.   Radiology.. 1996;  200 851-6

Received for Publication: December 9, 1998