REGULAR CONTENT
Final ID
515
Type
Original Scientific Research-Oral or Pos
Authors
P Krishnakurup1, I Lobko2, C Sung3, D Siegel4
Institutions
1Hofstra Northwell Health School of Medicine at NSLIJ, New Hyde Park, NY, 2N/A, Syosset, NY, 3Long Island Jewish Medical Center, New Hyde, NY, 4Northwell Health, New Hyde Park, NY
Purpose
Since the advent of wedge resection with VATS (Video Assisted Thoracic Surgery) there has been a need for preoperative localization of lung nodules that are not visible or palpable during the surgery. There are several methods used for localization such as using a hookwire, embolization microcoils and the administration of methylene blue. We have found that utilizing each one of these methods by itself has its own disadvantages. Our purpose is to describe a technique which is an amalgam of two known techniques, embolization coil placement and methylene blue administration, for lung nodule localization prior to wedge resection. We would like to report our results, analyze complications and compare our method with a singular method for localization.
Materials & Methods
Procedure Technique:1) Utilize CT for guidance in order to localize the lung nodule. 2) 1% Lidocaine for local anesthesia. 3) Introduce a 21 ¬gauge trocar needle to the lung nodule. 4) Under intermittent CT imaging inject a small amount, typically 0.1-0.2 ml, of methylene blue and simultaneously deploy a pushable .018 embolization coil to the nodule with extension to the pleural surface. 5) Remove the needle and achieve hemostasis with manual compression.Apply sterile dressing. 20 lung nodules were localized using this method in 17 patients from Nov 2015-Aug 2016. Two lung nodules were marked in the same session for three of these patients. The remaining fourteen had one lung nodule marked. Surgical Pathology reports were utilized to evaluate for resection of the marked nodules in all 17 patients. Comparison to current singlular localization methods will be performed by analyzing the percent of marked lung nodules that are resected and confirmed by pathology.
Results
For these 17 patients, 20 lung nodules were marked with 100% of the lung nodules being identified and resected with pathological confirmation. None of the patients experienced any major complications.
Conclusions
The combination technique of methylene blue and microcoils for localization of lung nodules appears to be superior to any singular localization method.
Final ID
515
Type
Original Scientific Research-Oral or Pos
Authors
P Krishnakurup1, I Lobko2, C Sung3, D Siegel4
Institutions
1Hofstra Northwell Health School of Medicine at NSLIJ, New Hyde Park, NY, 2N/A, Syosset, NY, 3Long Island Jewish Medical Center, New Hyde, NY, 4Northwell Health, New Hyde Park, NY
Purpose
Since the advent of wedge resection with VATS (Video Assisted Thoracic Surgery) there has been a need for preoperative localization of lung nodules that are not visible or palpable during the surgery. There are several methods used for localization such as using a hookwire, embolization microcoils and the administration of methylene blue. We have found that utilizing each one of these methods by itself has its own disadvantages. Our purpose is to describe a technique which is an amalgam of two known techniques, embolization coil placement and methylene blue administration, for lung nodule localization prior to wedge resection. We would like to report our results, analyze complications and compare our method with a singular method for localization.
Materials & Methods
Procedure Technique:1) Utilize CT for guidance in order to localize the lung nodule. 2) 1% Lidocaine for local anesthesia. 3) Introduce a 21 ¬gauge trocar needle to the lung nodule. 4) Under intermittent CT imaging inject a small amount, typically 0.1-0.2 ml, of methylene blue and simultaneously deploy a pushable .018 embolization coil to the nodule with extension to the pleural surface. 5) Remove the needle and achieve hemostasis with manual compression.Apply sterile dressing. 20 lung nodules were localized using this method in 17 patients from Nov 2015-Aug 2016. Two lung nodules were marked in the same session for three of these patients. The remaining fourteen had one lung nodule marked. Surgical Pathology reports were utilized to evaluate for resection of the marked nodules in all 17 patients. Comparison to current singlular localization methods will be performed by analyzing the percent of marked lung nodules that are resected and confirmed by pathology.
Results
For these 17 patients, 20 lung nodules were marked with 100% of the lung nodules being identified and resected with pathological confirmation. None of the patients experienced any major complications.
Conclusions
The combination technique of methylene blue and microcoils for localization of lung nodules appears to be superior to any singular localization method.