CT-GUIDED LOCALIZATIONS OF PULMONARY NODULES WITH METHYLENE-BLUE INJECTIONS FOR THORACOSCOPIC RESECTIONS

As only peripheral subpleural lesions can be visualized at thoracoscop y, deep nonpalpable pulmonary nodules have to be identified before per forming wedge resections. We evaluate the efficiency of computed tomog raphic (CT) guided methylene blue injections to localize these nodules before their thoracoscopic resection. Twenty-three nodules in 21 pati ents were preoperatively localized under CT guidance and marked with m ethylene blue injections. The localizations under CT guidance of the 2 3 nodules were successful in all cases. The surgeon confirmed accurate localization of 22 nodules. In one case, the injected methylene blue could not be identified during thoracoscopy. Complications of this tec hnique included six cases of asymptomatic pneumothorax, four cases of local and asymptomatic pulmonary hemorrhage, and two cases of fit of c oughing. Because of this technique, 22 thoracotomies could be avoided and the duration of the hospital stay was then reduced. Computed tomog raphic-guided localization with methylene blue injection is a simple, effective, and rapid technique enabling good thoracoscopic surgery res ults.