Preoperative Marking Using Endobronchial Ultrasonography with a Guide-sheath for a Small Pulmonary Nodule: a Case Report
Background. Various marking techniques for the identification of small impalpable lung nodules have been reported. Case. A 72-year-old man who had undergone surgery for bladder and rectal cancer presented with a solitary small lung tumor located in the right S3 on chest computed tomography (CT). Due...
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| Published in | The Journal of the Japan Society for Respiratory Endoscopy Vol. 44; no. 6; pp. 437 - 441 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japan Society for Respiratory Endoscopy
25.11.2022
特定非営利活動法人 日本呼吸器内視鏡学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0287-2137 2186-0149 |
| DOI | 10.18907/jjsre.44.6_437 |
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| Abstract | Background. Various marking techniques for the identification of small impalpable lung nodules have been reported. Case. A 72-year-old man who had undergone surgery for bladder and rectal cancer presented with a solitary small lung tumor located in the right S3 on chest computed tomography (CT). Due to tumor enlargement, it was suspected to be metastatic; thus, surgery was performed. Because the tumor was located near the B3bi, we performed presurgical coil marking using an endobronchial ultrasonography with a guide-sheath. During surgery, we identified the marking coil using X-ray fluoroscopy and subsequently resected the target tumor and marking coil. Conclusion. This method was safe and useful for marking small impalpable lung nodules. |
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| AbstractList | Background. Various marking techniques for the identification of small impalpable lung nodules have been reported. Case. A 72-year-old man who had undergone surgery for bladder and rectal cancer presented with a solitary small lung tumor located in the right S3 on chest computed tomography (CT). Due to tumor enlargement, it was suspected to be metastatic; thus, surgery was performed. Because the tumor was located near the B3bi, we performed presurgical coil marking using an endobronchial ultrasonography with a guide-sheath. During surgery, we identified the marking coil using X-ray fluoroscopy and subsequently resected the target tumor and marking coil. Conclusion. This method was safe and useful for marking small impalpable lung nodules. Background. Various marking techniques for the identification of small impalpable lung nodules have been reported. Case. A 72-year-old man who had undergone surgery for bladder and rectal cancer presented with a solitary small lung tumor located in the right S3 on chest computed tomography (CT). Due to tumor enlargement, it was suspected to be metastatic; thus, surgery was performed. Because the tumor was located near the B3bi, we performed presurgical coil marking using an endobronchial ultrasonography with a guide-sheath. During surgery, we identified the marking coil using X-ray fluoroscopy and subsequently resected the target tumor and marking coil. Conclusion. This method was safe and useful for marking small impalpable lung nodules. 背景．触知困難な肺末梢小型病変を術中に同定するために，これまで様々な方法が報告されている．今回我々は術前にガイドシース併用気管支腔内超音波断層法（endobronchial ultrasonography with a guide-sheath；EBUS-GS）を用いた経気管支的マーキングが有用であった1例を経験したので報告する．症例．72歳男性．膀胱癌，直腸癌の術後で経過観察中，右肺S3の小結節が増大しているとのことで転移性肺腫瘍の疑いで当科に紹介，手術の方針となった．結節が小さく術中に触知することは困難と考えられたので，術前にマーキングを行う方針とした．結節の辺縁にB3biが走行していることに着目し，EBUS-GSを用いてマイクロコイルによるマーキングを行い，処置後にCT検査で結節の近傍にマイクロコイルが留置されていることを確認した．手術ではX線透視を用いてコイルを確認し肺部分切除を行った．結論．適応症例に制限はあるものの，本法は術前マーキングの選択肢のひとつとして有用であると考えられた． |
| Author | Tsuboi, Mitsuhiro Mori, Ayaka Haku, Takashi Matsumoto, Daisuke Miyamoto, Kenya Bandou, Noriko Imakura, Takeshi Hirose, Toshiyuki Kakiuchi, Souji Inayama, Mami |
| Author_FL | 坪井 光弘 広瀬 敏幸 松本 大資 Haku Takashi 坂東 紀子 森 彩花 宮本 憲哉 Inayama Mami 今倉 健 柿内 聡司 |
| Author_FL_xml | – sequence: 1 fullname: 坪井 光弘 – sequence: 2 fullname: 宮本 憲哉 – sequence: 3 fullname: 柿内 聡司 – sequence: 4 fullname: 坂東 紀子 – sequence: 5 fullname: 今倉 健 – sequence: 6 fullname: Inayama Mami – sequence: 7 fullname: 森 彩花 – sequence: 8 fullname: 松本 大資 – sequence: 9 fullname: 広瀬 敏幸 – sequence: 10 fullname: Haku Takashi |
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| References | 6. 中野哲宏, 清水公裕, 大谷嘉己, ほか. CTガイド下経皮的肺針生検による空気塞栓に対して高圧酸素療法が奏効した1例. 日呼外会誌. 2007;21:859-864. 9. Yamada T, Koyama Y, Masui A, et al. Fluoroscopy-guided barium marking for localizing small pulmonary lesions before video-assisted thoracoscopic surgery. J Jpn Soc Resp Endoscopy. 2009;31:62-67. 12. Miyoshi T, Kondo K, Takizawa H, et al. Fluoroscopy-assisted thoracoscopic resection of pulmonary nodules after computed tomography-guided bronchoscopic metallic coil marking. J Thorac Cardiovasc Surg. 2006;131:704-710. 4. Sakiyama S, Kondo K, Matsuoka H, et al. Fatal air embolism during computed tomography-guided pulmonary marking with a hook-type marker. J Thorac Cardiovasc Surg. 2003;126:1207-1209. 5. 松浦陽介, 渡 正伸. CTガイド下肺穿刺後に心腔内空気栓を生じた2症例. 日呼外会誌. 2010;24:967-971. 11. Ikeda K, Nomori H, Mori T, et al. Impalpable pulmonary nodules with ground-glass opacity: Success for making pathologic sections with preoperative marking by lipiodol. Chest. 2007;131:502-506. 8. Sakamoto T, Takada Y, Endoh M, et al. Bronchoscopic dye injection for localization of small pulmonary nodules in thoracoscopic surgery. Ann Thorac Surg. 2001;72:296-297. 2. Sinner WN. Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn. 1976;17:813-828. 1. 佐藤雅昭. 小型肺癌の術中局在同定法-術前マーキング法とvirtual-assisted lung mapping-. 肺癌. 2014;54:835-842. 15. Fukasawa M, Misawa M, Abe M, et al. Intraoperative marking using endobronchial ultrasonography with a guide sheath and a bronchoscopic navigation system for difficult-to-detect small pulmonary ground-glass opacities. J Jpn Soc Respir Endoscopy. 2014;36:7-11. 3. 及川武史, 野本靖史, 木下孔明. 小型末梢肺癌に対するCTガイド下マーキング時に生じた脳空気塞栓により左半身麻痺が残存した1例. 日呼外会誌. 2008;22:914-919. 7. Krimsky WS, Minnich DJ, Cattaneo SM, et al. Thoracoscopic detection of occult indeterminate pulmonary nodules using bronchoscopic pleural dye marking. J Community Hosp Intern Med Perspect. 2014;4 doi: 10.3402/jchimp.v4.23084. 10. Nomori H, Horio H, Naruke T, et al. Fluoroscopy-assisted thoracoscopic resection of lung nodules marked with lipiodol. Ann Thorac Surg. 2002;74:170-173. 13. Toba H, Kondo K, Miyoshi T, et al. Fluoroscopy-assisted thoracoscopic resection after computed tomography-guided bronchoscopic metallic coil marking for small peripheral pulmonary lesions. Eur J Cardiothorac Surg. 2013;44:e126-e132. 14. 光岡正浩, 寺崎泰宏, 岡本祐介, ほか. 触知不能肺野末梢病巣に対して血管ハイブリッド手術用X線撮影装置を用いた術中マーキング法. 日呼外会誌. 2015;29:552-558. |
| References_xml | – reference: 2. Sinner WN. Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn. 1976;17:813-828. – reference: 7. Krimsky WS, Minnich DJ, Cattaneo SM, et al. Thoracoscopic detection of occult indeterminate pulmonary nodules using bronchoscopic pleural dye marking. J Community Hosp Intern Med Perspect. 2014;4 doi: 10.3402/jchimp.v4.23084. – reference: 13. Toba H, Kondo K, Miyoshi T, et al. Fluoroscopy-assisted thoracoscopic resection after computed tomography-guided bronchoscopic metallic coil marking for small peripheral pulmonary lesions. Eur J Cardiothorac Surg. 2013;44:e126-e132. – reference: 4. Sakiyama S, Kondo K, Matsuoka H, et al. Fatal air embolism during computed tomography-guided pulmonary marking with a hook-type marker. J Thorac Cardiovasc Surg. 2003;126:1207-1209. – reference: 6. 中野哲宏, 清水公裕, 大谷嘉己, ほか. CTガイド下経皮的肺針生検による空気塞栓に対して高圧酸素療法が奏効した1例. 日呼外会誌. 2007;21:859-864. – reference: 8. Sakamoto T, Takada Y, Endoh M, et al. Bronchoscopic dye injection for localization of small pulmonary nodules in thoracoscopic surgery. Ann Thorac Surg. 2001;72:296-297. – reference: 15. Fukasawa M, Misawa M, Abe M, et al. Intraoperative marking using endobronchial ultrasonography with a guide sheath and a bronchoscopic navigation system for difficult-to-detect small pulmonary ground-glass opacities. J Jpn Soc Respir Endoscopy. 2014;36:7-11. – reference: 1. 佐藤雅昭. 小型肺癌の術中局在同定法-術前マーキング法とvirtual-assisted lung mapping-. 肺癌. 2014;54:835-842. – reference: 11. Ikeda K, Nomori H, Mori T, et al. Impalpable pulmonary nodules with ground-glass opacity: Success for making pathologic sections with preoperative marking by lipiodol. Chest. 2007;131:502-506. – reference: 5. 松浦陽介, 渡 正伸. CTガイド下肺穿刺後に心腔内空気栓を生じた2症例. 日呼外会誌. 2010;24:967-971. – reference: 12. Miyoshi T, Kondo K, Takizawa H, et al. Fluoroscopy-assisted thoracoscopic resection of pulmonary nodules after computed tomography-guided bronchoscopic metallic coil marking. J Thorac Cardiovasc Surg. 2006;131:704-710. – reference: 9. Yamada T, Koyama Y, Masui A, et al. Fluoroscopy-guided barium marking for localizing small pulmonary lesions before video-assisted thoracoscopic surgery. J Jpn Soc Resp Endoscopy. 2009;31:62-67. – reference: 14. 光岡正浩, 寺崎泰宏, 岡本祐介, ほか. 触知不能肺野末梢病巣に対して血管ハイブリッド手術用X線撮影装置を用いた術中マーキング法. 日呼外会誌. 2015;29:552-558. – reference: 3. 及川武史, 野本靖史, 木下孔明. 小型末梢肺癌に対するCTガイド下マーキング時に生じた脳空気塞栓により左半身麻痺が残存した1例. 日呼外会誌. 2008;22:914-919. – reference: 10. Nomori H, Horio H, Naruke T, et al. Fluoroscopy-assisted thoracoscopic resection of lung nodules marked with lipiodol. Ann Thorac Surg. 2002;74:170-173. |
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| Snippet | Background. Various marking techniques for the identification of small impalpable lung nodules have been reported. Case. A 72-year-old man who had undergone... |
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| SubjectTerms | Bronchoscopic marking Endobronchial ultrasonography with a guide-sheath (EBUS-GS) Small pulmonary nodule VATS ガイドシース併用気管支腔内超音波断層法（EBUS-GS） 小型肺結節 気管支鏡下マーキング 胸腔鏡手術 |
| Title | Preoperative Marking Using Endobronchial Ultrasonography with a Guide-sheath for a Small Pulmonary Nodule: a Case Report |
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