Fluoroscopy-assisted thoracoscopic surgery after computed tomography-guided bronchoscopic barium marking

Background. Small lesions of the peripheral lung have been detected more fr equently with the recent prevalence of computed tomography (CT). Identifica tion of these lesions is indispensable for wedge resection performed by vid eo-assisted thoracic surgery. Previous reports of marking techniques showed some failure and complications. We have developed a new marking technique and herein describe the efficacy of this technique: fluoroscopy-assisted th oracoscopic surgery after computed tomography-guided bronchoscopic barium m arking. Methods. Twenty patients underwent this procedure for 21 small peripheral p ulmonary lesions approximately 10 mm in size. Results. All the lesions were successfully marked and identified during flu oroscopy-assisted thoracoscopy. They were resected with sufficient margins. There were no complications related to this procedure, The pathologic exam ination of these 21 lesions revealed primary lung cancer in 14, atypical ad enomatous hyperplasia in four, a metastatic tumor in one, and a benign tumo r in two. Conclusions. This procedure is both a reliable and minimally invasive techn ique in thoracoscopic wedge resection for small peripheral pulmonary lesion s. (C) 2001 by The Society of Thoracic Surgeons.