Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.

<h4>Purpose</h4>Thoracic surgeons are currently asked to resect smaller and deeper lesions which are difficult to detect thoracoscopically. The growing number of those lesions arises both from lung cancer screening programs and from follow-up of extrathoracic malignancies. This study ana...

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Autores principales:	Ioannis Karampinis, Nils Rathmann, Michael Kostrzewa, Steffen J Diehl, Stefan O Schoenberg, Peter Hohenberger, Eric D Roessner
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/718425f6b18d459fa82760bfc735c6cd
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spelling	oai:doaj.org-article:718425f6b18d459fa82760bfc735c6cd2021-12-02T20:04:30ZComputer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.1932-620310.1371/journal.pone.0258896https://doaj.org/article/718425f6b18d459fa82760bfc735c6cd2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258896https://doaj.org/toc/1932-6203<h4>Purpose</h4>Thoracic surgeons are currently asked to resect smaller and deeper lesions which are difficult to detect thoracoscopically. The growing number of those lesions arises both from lung cancer screening programs and from follow-up of extrathoracic malignancies. This study analyzed the routine use of a CT-aided thoracoscopic approach to small pulmonary nodules in the hybrid theatre and the resulting changes in the treatment pathway.<h4>Methods</h4>50 patients were retrospectively included. The clinical indication for histological diagnosis was suspected metastasis in 46 patients. Technically, the radiological distance between the periphery of the lesion and the visceral pleura had to exceed the maximum diameter of the lesion for the patient to be included. A spiral wire was placed using intraoperative CT-based laser navigation to guide the thoracoscopic resection.<h4>Results</h4>The mean diameter of the lesions was 8.4 mm (SD 4.27 mm). 29.4 minutes (SD 28.5) were required on average for the wire placement and 42.3 minutes (SD 20.1) for the resection of the lesion. Histopathology confirmed the expected diagnosis in 30 of 52 lesions. In the remaining 22 lesions, 9 cases of primary lung cancer were detected while 12 patients showed a benign disease.<h4>Conclusion</h4>Computer tomography assisted thoracoscopic surgery (CATS) enabled successful resection in all cases with minimal morbidity. The histological diagnosis led to a treatment change in 42% of the patients. The hybrid-CATS technique provides good access to deeply located small pulmonary nodules and could be particularly valuable in the emerging setting of lung cancer screening.Ioannis KarampinisNils RathmannMichael KostrzewaSteffen J DiehlStefan O SchoenbergPeter HohenbergerEric D RoessnerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0258896 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ioannis Karampinis Nils Rathmann Michael Kostrzewa Steffen J Diehl Stefan O Schoenberg Peter Hohenberger Eric D Roessner Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
description	<h4>Purpose</h4>Thoracic surgeons are currently asked to resect smaller and deeper lesions which are difficult to detect thoracoscopically. The growing number of those lesions arises both from lung cancer screening programs and from follow-up of extrathoracic malignancies. This study analyzed the routine use of a CT-aided thoracoscopic approach to small pulmonary nodules in the hybrid theatre and the resulting changes in the treatment pathway.<h4>Methods</h4>50 patients were retrospectively included. The clinical indication for histological diagnosis was suspected metastasis in 46 patients. Technically, the radiological distance between the periphery of the lesion and the visceral pleura had to exceed the maximum diameter of the lesion for the patient to be included. A spiral wire was placed using intraoperative CT-based laser navigation to guide the thoracoscopic resection.<h4>Results</h4>The mean diameter of the lesions was 8.4 mm (SD 4.27 mm). 29.4 minutes (SD 28.5) were required on average for the wire placement and 42.3 minutes (SD 20.1) for the resection of the lesion. Histopathology confirmed the expected diagnosis in 30 of 52 lesions. In the remaining 22 lesions, 9 cases of primary lung cancer were detected while 12 patients showed a benign disease.<h4>Conclusion</h4>Computer tomography assisted thoracoscopic surgery (CATS) enabled successful resection in all cases with minimal morbidity. The histological diagnosis led to a treatment change in 42% of the patients. The hybrid-CATS technique provides good access to deeply located small pulmonary nodules and could be particularly valuable in the emerging setting of lung cancer screening.
format	article
author	Ioannis Karampinis Nils Rathmann Michael Kostrzewa Steffen J Diehl Stefan O Schoenberg Peter Hohenberger Eric D Roessner
author_facet	Ioannis Karampinis Nils Rathmann Michael Kostrzewa Steffen J Diehl Stefan O Schoenberg Peter Hohenberger Eric D Roessner
author_sort	Ioannis Karampinis
title	Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
title_short	Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
title_full	Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
title_fullStr	Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
title_full_unstemmed	Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
title_sort	computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/718425f6b18d459fa82760bfc735c6cd
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Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre.

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