We have located links that may give you full text access.
Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue.
AJR. American Journal of Roentgenology 1994 August
OBJECTIVE: Video-assisted thoracic surgery (VATS) is a new procedure that makes it possible to see the intrathoracic organs and to resect pulmonary nodules without thoracotomy. Preoperative localization of small nodules that may not be visible or palpable during VATS is desirable. Percutaneous placement of spring hookwires is widely used to localize pulmonary nodules before VATS; infrequently, the adjacent lung parenchyma is also stained with methylene blue. The purpose of this study was to evaluate the effectiveness of methylene blue staining of pulmonary nodules without placement of a hookwire.
SUBJECTS AND METHODS: Fifteen pulmonary nodules in 15 patients were localized preoperatively under CT guidance by using techniques identical to those for CT-guided fine-needle aspiration of pulmonary nodules. Approximately 0.3 ml of methylene blue dye was injected into the nodule with a 22-gauge Chiba needle to stain the nodule, the needle pathway, and the visceral pleura. In two patients, a hookwire also was placed. All patients had solitary nodules in which transbronchial or transthoracic biopsy had been unsuccessful. The mean nodule diameter was 16 mm (range, 8-33 mm), and the mean distance to the nearest pleural surface was 10 mm (range, 0-21 mm). The localization procedure required a mean of 32 min (range, 18-47 min).
RESULTS: All 15 nodules were stained successfully either in the center or within the margins; the two hookwires were found to be displaced. In three cases, pulmonary hemorrhage occurred as a complication of the percutaneous staining procedure: in one case, subsequent conversion to thoracotomy was necessary owing to pulmonary hemorrhage and additional pleural bleeding during VATS, which resulted from puncture with a trocar directly into the pleural adhesions. Anticipated complications, such as pneumothorax, occurred in five patients; one patient had pleuritic pain, but none required treatment. In one patient, conversion to thoracotomy was done so that an adenocarcinoma could be treated by means of a lobectomy. In two others, thoracotomy was done because of problems with technical devices.
CONCLUSIONS: Percutaneous staining of pulmonary nodules is an accurate technique for localizing nodules before VATS. The procedure is easily and safely performed, and it obviates wire-related complications, such as severe pleuritic pain.
SUBJECTS AND METHODS: Fifteen pulmonary nodules in 15 patients were localized preoperatively under CT guidance by using techniques identical to those for CT-guided fine-needle aspiration of pulmonary nodules. Approximately 0.3 ml of methylene blue dye was injected into the nodule with a 22-gauge Chiba needle to stain the nodule, the needle pathway, and the visceral pleura. In two patients, a hookwire also was placed. All patients had solitary nodules in which transbronchial or transthoracic biopsy had been unsuccessful. The mean nodule diameter was 16 mm (range, 8-33 mm), and the mean distance to the nearest pleural surface was 10 mm (range, 0-21 mm). The localization procedure required a mean of 32 min (range, 18-47 min).
RESULTS: All 15 nodules were stained successfully either in the center or within the margins; the two hookwires were found to be displaced. In three cases, pulmonary hemorrhage occurred as a complication of the percutaneous staining procedure: in one case, subsequent conversion to thoracotomy was necessary owing to pulmonary hemorrhage and additional pleural bleeding during VATS, which resulted from puncture with a trocar directly into the pleural adhesions. Anticipated complications, such as pneumothorax, occurred in five patients; one patient had pleuritic pain, but none required treatment. In one patient, conversion to thoracotomy was done so that an adenocarcinoma could be treated by means of a lobectomy. In two others, thoracotomy was done because of problems with technical devices.
CONCLUSIONS: Percutaneous staining of pulmonary nodules is an accurate technique for localizing nodules before VATS. The procedure is easily and safely performed, and it obviates wire-related complications, such as severe pleuritic pain.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
Perioperative echocardiographic strain analysis: what anesthesiologists should know.Canadian Journal of Anaesthesia 2024 April 11
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app