METHYLENE-BLUE LOCALIZATIONS OF PULMONARY NODULES UNDER CT-GUIDANCE -A NEW PROCEDURE USED BEFORE THORACOSCOPIC RESECTIONS

With the expending use of video-assisted thoracoscopy for a wide range of indications, we present our experience of CT-guided localizations of pulmonary nodules with methylene blue injections before their thora coscopic resections, This technique was developed for deep non-palpabl e nodules of small size. Forty seven nodules in 44 patients were preop eratively localized under CT guidance and marked with methylene blue i njections. The localizations under CT guidance of the 47 nodules were successful in all cases, The surgeon confirmed accurate localization o f 46 nodules, In one case, the injected methylene blue could not be id entified during thoracoscopy. Complications of this technique included 7 cases of asymptomatic pneumothorax, 5 cases of local and asymptomat ic pulmonary hemorrhage, and 2 cases of fits of coughing. Because of t his technique, 46 diagnostic thoracotomies could be avoided, CT guided localization with methylene blue injection is a simple and rapid tech nique enabling good thoracoscopic surgery results.