Preoperative Computed Tomography-Guided Localization for Pulmonary Nodules with Glue and Dye

Thorac Cardiovasc Surg. 2020 Sep;68(6):525-532. doi: 10.1055/s-0039-3400999. Epub 2020 Mar 1.

Abstract

Background: This study was aimed to describe a new localization technique developed using medical glue and methylene blue dye, and characterized the localization results and postoperative outcome to evaluate its safety and usefulness.

Methods: This retrospective study was conducted at our center from January 2016 to April 2018. Totally 346 consecutive patients with 383 nodules who underwent preoperative computed tomography (CT)-guided medical glue and methylene blue dye localization, followed by lung resection, were enrolled in this study.

Results: Mean nodule size was 7.7 ± 3.7 mm (range: 2-30 mm), with a mean depth from pleura or fissure of 9.4 ± 9.3 mm (range: 0-60 mm). The success rate of CT-guided localization for pulmonary nodules was 99.5% (381/383) of the nodules. Localization-related complications included mild pneumothorax in 16 (4.6%) patients, mild hemothorax in 7 (2.0%) patients, and hemoptysis in 1 (0.3%) patient. Pleural reaction occurred in 7 (2.0%) and pain in 25 (7.2%) patients. All 383 nodules were resected successfully, with conversion to thoracotomy only required in two patients for adhesion and calcification of lymph nodes. All patients recovered well postoperatively, with a short postoperative hospital stay (3.7 ± 2.0 days) and a low complication rate (2.6%, 9/346).

Conclusion: CT-guided medical glue and methylene blue dye localization prior to video-assisted thoracoscopic surgery (VATS) lung resection was a novel, safe, and technically feasible method, with a high-technical success rate and a low-complication rate. It allowed surgeons to easily locate and detect the nodules and estimate the surgical margin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Video-Audio Media

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coloring Agents / administration & dosage*
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Methylene Blue / administration & dosage*
  • Middle Aged
  • Multiple Pulmonary Nodules / diagnostic imaging
  • Multiple Pulmonary Nodules / pathology*
  • Multiple Pulmonary Nodules / surgery
  • Pneumonectomy
  • Predictive Value of Tests
  • Retrospective Studies
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Solitary Pulmonary Nodule / pathology*
  • Solitary Pulmonary Nodule / surgery
  • Tissue Adhesives / administration & dosage*
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Tumor Burden
  • Young Adult

Substances

  • Coloring Agents
  • Tissue Adhesives
  • Methylene Blue