ECTSS Home  |  Past Meetings
Eastern Cardiothoracic Surgical Society

Back to 2021 Posters


Finding a Needle in a Haystack: An Academic Institutionís Experience with IR Localization of Pulmonary Lesions
Joshua S. Newman, Stevan S. Pupovac, Miguel Alexis, Lawrence Glassman, Paul C. Lee, Kevin Hyman, Julissa Jurado, David Zeltsman.
Northwell Health, New Hyde Park, NY, USA.

OBJECTIVE:
Video assisted thoracoscopic surgery (VATS) has reduced the morbidity associated with lung resection. The lung collapse necessary for VATS has made intraoperative localization of small solid and semi-solid lesions challenging. We demonstrate the efficacy of preoperative marking of small parenchymal lesions to allow successful intraoperative localization.
METHODS:
A retrospective review was conducted for patients having undergone IR localization prior to resection over a 4 year period. Institutional data submitted to the General Thoracic Surgery Database (GTSD) of the Society of Thoracic Surgeons (STS) was queried for patients having undergone lung resection with preoperative IR marking. Additional datapoints were obtained from review of the electronic medical record as appropriate.
RESULTS:
Fifty-one patients underwent preoperative IR marking with subsequent resection during the study period. The average age was 66.9 years, and the average lesion was less than 10mm. Patients underwent marking with blue dye (47%), metal coil (8%) or both (45%). Lesion localization with initial specimen was 100%.
The average operating room time was 75 minutes with an average stay of 2.3 days. No clinically significant complications resulted from the marking. Adenocarcinoma was the most common lesion (68%) and most lesions were in the right upper lobe (39%).
CONCLUSIONS:
We demonstrate the safety, efficacy, and efficiency of preoperative CT guided localization prior to pulmonary resection to allow a very high degree of successful intraoperative localization of small pulmonary nodules. As imaging technology allows for better identification of small pulmonary lesions, the ability to localize these lesions is ever more important.


Back to 2021 Posters