CT-guided color marking of impalpable pulmonary nodules prior to video-assisted thoracoscopic surgery.

Abstract

OBJECTIVES\nTo investigate the utility and complications of computed tomography (CT)-guided color marking of impalpable pulmonary nodules for video-assisted thoracoscopic surgical resection.\n\n\nMETHODS\nThis retrospective single institutional study has obtained Institutional Review Board approval. A total of 174 patients with 207 undiagnosed peripheral lesions of the lung were enrolled who had undergone preoperative computed tomography-guided color marking using colored collagen followed by video-assisted thoracoscopic surgery (VATS) from December 2015 to September 2018.\n\n\nRESULTS\nAll nodules (mean 14.0\xa0mm, range 3.0-30.0\xa0mm) were successfully marked by computed tomography-guided color marking, and 96.0% cases (167/174) were localized by means of intraoperative fluoroscopy as clear spots. Minor pneumothorax with a median volume of 3.8\xa0mL (range 0.2-119.0\xa0mL) occurred in 12 patients (6.9%) who were completely asymptomatic and were not in serious condition. No patient required a chest tube. No major bleeding complication occurred, and no air emboli were seen. No intra- or post-operative mortality of VATS was observed.\n\n\nCONCLUSIONS\nPreoperative CT-guided color marking of impalpable pulmonary nodules is a safe and effective procedure that allows for successful surgical resection.