A new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions

Shentu, Yang, Zhang, Liang, Gu, Hengle, Mao, Feng, Cai, Minghui, Ding, Zhengping and Wang, Zhiqiang (2014) A new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions. BMC Cancer, 14 79: 1-8. doi:10.1186/1471-2407-14-79


Author Shentu, Yang
Zhang, Liang
Gu, Hengle
Mao, Feng
Cai, Minghui
Ding, Zhengping
Wang, Zhiqiang
Title A new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions
Journal name BMC Cancer   Check publisher's open access policy
ISSN 1471-2407
Publication date 2014-02-11
Sub-type Article (original research)
DOI 10.1186/1471-2407-14-79
Open Access Status DOI
Volume 14
Issue 79
Start page 1
End page 8
Total pages 8
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2015
Language eng
Formatted abstract
Background Quickly and accurately localizing small peripheral pulmonary lesions can avoid prolonged operative time and unplanned open thoracotomy. In this study, we aimed to introduce and evaluate a new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions.

Methods Seventy four (74) patients with 80 peripheral pulmonary lesions <20 mm in size on computer tomography (CT) were virtually punctured using a radiotherapy planning simulator on the day before operation. Under general anaesthesia, methylene blue dye was injected to the virtually identified point according to the surface point, angle and depth previously determined by the simulator. The wedge resection of the marked lesion was performed under video-assisted thoracoscopic surgery (VATS) and the specimens were sent for immediate pathologic examination. According to pathology results, appropriate surgical procedures were decided and undertaken.

Results The average lesion size was 10.4±3.5 mm (range: 4-17 mm) and the average distance to the pleural surface was 9.4±4.9 mm. Our preoperative localization procedure was successful in 75 of 80 (94%) lesions. Histological examination showed 28 benign lesions and 52 lung cancers. The shortest distance between the edges of the stain and lesion was 5.1±3.1 mm. Localization time was 17.4±2.3 min. All patients with malignant lesions subsequently underwent lobectomy and systematic lymph node dissection. No complications were observed in all participants.

Conclusions The novel technique combining the preoperative virtual simulation and methylene blue staining techniques has a high success rate for localizing small peripheral pulmonary lesions, particularly for those tiny lesions which are difficult to visualise and palpate during VATS.
Keyword Lung cancer
Pulmonary lesions
Thoracoscopy
Localization
Simulation
Methylene blue
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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Created: Tue, 11 Feb 2014, 15:44:07 EST by Zhiqiang Wang on behalf of Medicine - Royal Brisbane and Women's Hospital