Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective
Objective: The objective of this study was to use cone-beam computed tomography (CBCT) for intraoperative imaging of a pulmonary wedge resection line that contributes to securing the required surgical margin in patients undergoing thoracoscopic surgery for indistinct intrapulmonary lesions. Methods:...
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Elsevier
2022-06-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250722001237 |
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| author | Kazuhiro Ueda, MD, PhD Masaya Aoki, MD, PhD Go Kamimura, MD Nobuhiro Imamura, MD Takuya Tokunaga, MD Soichi Suzuki, MD Masami Sato, MD, PhD |
| author_facet | Kazuhiro Ueda, MD, PhD Masaya Aoki, MD, PhD Go Kamimura, MD Nobuhiro Imamura, MD Takuya Tokunaga, MD Soichi Suzuki, MD Masami Sato, MD, PhD |
| author_sort | Kazuhiro Ueda, MD, PhD |
| collection | DOAJ |
| description | Objective: The objective of this study was to use cone-beam computed tomography (CBCT) for intraoperative imaging of a pulmonary wedge resection line that contributes to securing the required surgical margin in patients undergoing thoracoscopic surgery for indistinct intrapulmonary lesions. Methods: Data of 16 consecutive patients with potentially impalpable intrapulmonary lesions were retrospectively reviewed. Preoperatively, we simulated a rhomboidal cut line on the surface of a 3-dimensional lung model with reference to multiplanar reconstruction computed tomography images. Intraoperatively, we imaged the rhomboid on the real lung surface using trial and error adjustment with CBCT. Wedge resection was performed thoracoscopically by stapling along the outline of the rhomboid. Results: The mean consolidation diameter and mean distance between the tumor and the visceral pleura were 2 mm and 11 mm, respectively. In all cases, we only performed single CBCT scanning to localize the rhomboid on the real lung surface. The mean radiological distance between the approximate location and the correct location was 8 mm (range, 0-34 mm). Wedge resection was successful with a mean surgical margin of 11 mm (range, 7-16 mm), without conversion to anatomical resection or open conversion. This simulation was also helpful for planning port placement for the use of an autostapler. Conclusions: We established a novel procedure for imaging the cut line on the lung surface with intraoperative CBCT, which facilitated the performance of wedge resection with the required surgical margin in patients with potentially impalpable intrapulmonary small lesions. Our method might be beneficial for patients and surgeons because it can be applied without preoperative intervention. |
| format | Article |
| id | doaj-art-edef57ee2cd94e99b9abb25e164977d7 |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-edef57ee2cd94e99b9abb25e164977d72025-08-20T03:36:37ZengElsevierJTCVS Techniques2666-25072022-06-011321922810.1016/j.xjtc.2022.01.028Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspectiveKazuhiro Ueda, MD, PhD0Masaya Aoki, MD, PhD1Go Kamimura, MD2Nobuhiro Imamura, MD3Takuya Tokunaga, MD4Soichi Suzuki, MD5Masami Sato, MD, PhD6Address for reprints: Kazuhiro Ueda, MD, PhD, Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.; Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanDepartment of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanDepartment of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanDepartment of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanDepartment of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanDepartment of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanDepartment of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, JapanObjective: The objective of this study was to use cone-beam computed tomography (CBCT) for intraoperative imaging of a pulmonary wedge resection line that contributes to securing the required surgical margin in patients undergoing thoracoscopic surgery for indistinct intrapulmonary lesions. Methods: Data of 16 consecutive patients with potentially impalpable intrapulmonary lesions were retrospectively reviewed. Preoperatively, we simulated a rhomboidal cut line on the surface of a 3-dimensional lung model with reference to multiplanar reconstruction computed tomography images. Intraoperatively, we imaged the rhomboid on the real lung surface using trial and error adjustment with CBCT. Wedge resection was performed thoracoscopically by stapling along the outline of the rhomboid. Results: The mean consolidation diameter and mean distance between the tumor and the visceral pleura were 2 mm and 11 mm, respectively. In all cases, we only performed single CBCT scanning to localize the rhomboid on the real lung surface. The mean radiological distance between the approximate location and the correct location was 8 mm (range, 0-34 mm). Wedge resection was successful with a mean surgical margin of 11 mm (range, 7-16 mm), without conversion to anatomical resection or open conversion. This simulation was also helpful for planning port placement for the use of an autostapler. Conclusions: We established a novel procedure for imaging the cut line on the lung surface with intraoperative CBCT, which facilitated the performance of wedge resection with the required surgical margin in patients with potentially impalpable intrapulmonary small lesions. Our method might be beneficial for patients and surgeons because it can be applied without preoperative intervention.http://www.sciencedirect.com/science/article/pii/S2666250722001237lung cancersubsolid tumorsublobar resectioncone-beam computed tomographyhybrid operating room |
| spellingShingle | Kazuhiro Ueda, MD, PhD Masaya Aoki, MD, PhD Go Kamimura, MD Nobuhiro Imamura, MD Takuya Tokunaga, MD Soichi Suzuki, MD Masami Sato, MD, PhD Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective JTCVS Techniques lung cancer subsolid tumor sublobar resection cone-beam computed tomography hybrid operating room |
| title | Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective |
| title_full | Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective |
| title_fullStr | Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective |
| title_full_unstemmed | Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective |
| title_short | Intraoperative cone-beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionsCentral MessagePerspective |
| title_sort | intraoperative cone beam computed tomography to secure the surgical margin in pulmonary wedge resection for indistinct intrapulmonary lesionscentral messageperspective |
| topic | lung cancer subsolid tumor sublobar resection cone-beam computed tomography hybrid operating room |
| url | http://www.sciencedirect.com/science/article/pii/S2666250722001237 |
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