Microcoil localization as an effective adjunct to Thoracoscopic resection of pulmonary nodules in children
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In brief
In brief
This multi-institutional study demonstrates that CT-guided microcoil localization is a reliable technique for thoracoscopic resection of small, deep pulmonary nodules in children, with 95% successful placement and 88% intraoperative localization success. The microcoil approach proved more durable than wire localization, which dislodged in 60% of cases.
Written by the GCMD Library team from the article.
Abstract
Background/Purpose
Thoracoscopic excision of pulmonary nodules is often required for diagnostic or therapeutic purposes, however subpleural and sub-centimeter nodules can be difficult to visualize. Various CT-guided localization techniques have been described, though there is minimal published pediatric data regarding the use of microcoils. We hypothesize that microcoil localization facilitates thoracoscopic resection of pulmonary nodules in children.
Methods
A multi-institutional retrospective review of children who underwent preoperative CT-guided localization of lung nodules was conducted from 2012 to 2019. A combination of methylene blue dye (MBD), wires, and microcoils were utilized for CT-guided localization. When microcoils were utilized, fluoroscopy assisted in lesion identification and resection.
Results
Eighteen patients (mean age 13 years, range 2–21 years) underwent thoracoscopic resection of 24 preoperatively localized pulmonary nodules. Mean size and depth of the lesions were 5.5 mm and 10 mm, respectively. Microcoil placement was successful 95% of the time and assisted in lesion localization in 88% of cases. Wire localization was not a durable technique, as 3 of 5 wires became dislodged upon lung isolation.
Conclusions
Preoperative CT-guided localization with microcoils can assist in fluoroscopic-guided resection of pulmonary nodules in children. This technique avoids the pitfall of wire dislodgement, and provides surgeons an additional technique to localize sub-centimeter, subpleural nodules.
Type of Study
Retrospective Review.
Level of Evidence
Level III.