Cargando…

Perioperative identifications of non-palpable pulmonary nodules: a narrative review

Early detection of lung cancer is the key to improving treatment and prognosis of this disease, and the advent of advances in computed tomography (CT) imaging and national screening programs have improved the detection rate of very small pulmonary lesions. As such, the management of this sub-centime...

Descripción completa

Detalles Bibliográficos
Autores principales: Imperatori, Andrea, Nardecchia, Elisa, Cattoni, Maria, Mohamed, Shehab, Di Natale, Davide, Righi, Ilaria, Mendogni, Paolo, Diotti, Cristina, Rotolo, Nicola, Dominioni, Lorenzo, Rosso, Lorenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107557/
https://www.ncbi.nlm.nih.gov/pubmed/34012598
http://dx.doi.org/10.21037/jtd-20-1712
_version_ 1783689978956480512
author Imperatori, Andrea
Nardecchia, Elisa
Cattoni, Maria
Mohamed, Shehab
Di Natale, Davide
Righi, Ilaria
Mendogni, Paolo
Diotti, Cristina
Rotolo, Nicola
Dominioni, Lorenzo
Rosso, Lorenzo
author_facet Imperatori, Andrea
Nardecchia, Elisa
Cattoni, Maria
Mohamed, Shehab
Di Natale, Davide
Righi, Ilaria
Mendogni, Paolo
Diotti, Cristina
Rotolo, Nicola
Dominioni, Lorenzo
Rosso, Lorenzo
author_sort Imperatori, Andrea
collection PubMed
description Early detection of lung cancer is the key to improving treatment and prognosis of this disease, and the advent of advances in computed tomography (CT) imaging and national screening programs have improved the detection rate of very small pulmonary lesions. As such, the management of this sub-centimetric and often sub-solid lesions has become quite challenging for clinicians, especially for choosing the most suitable diagnostic method. In clinical practice, to fulfill this diagnostic yield, transthoracic needle biopsy (TTNB) is often the first choice especially for peripheral nodules. For lesions for which TTNB could present technical difficulties or failed, other diagnostic strategies are needed. In this case, video-assisted thoracic surgery (VATS) is the gold standard to reach the diagnosis of lung nodules suspect of being malignant. Nonetheless it’s often not easy the identification of such lesions during VATS because of their little dimensions, non-firm consistency, deep localization. In literature various marking techniques have been described, in order to improve intraoperative nodules detection and to reduce conversion rate to thoracotomy: CT-guided hookwire positioning, methylene blue staining, intra-operative ultrasound and electromagnetic navigation bronchoscopy are the most used. The scientific evidence on this matter is weak because there are no randomized clinical trials but only case series on single techniques with no comparison on efficacy, so there are no guidelines to refer. From this standing, in this article we conducted a narrative review of the existing literature on the subject, with the aim of outlining a framework as complete as possible. We analyzed strengths and weaknesses of the main techniques reported, so as to allow the clinician to orient himself with greater ease.
format Online
Article
Text
id pubmed-8107557
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-81075572021-05-18 Perioperative identifications of non-palpable pulmonary nodules: a narrative review Imperatori, Andrea Nardecchia, Elisa Cattoni, Maria Mohamed, Shehab Di Natale, Davide Righi, Ilaria Mendogni, Paolo Diotti, Cristina Rotolo, Nicola Dominioni, Lorenzo Rosso, Lorenzo J Thorac Dis Review Article Early detection of lung cancer is the key to improving treatment and prognosis of this disease, and the advent of advances in computed tomography (CT) imaging and national screening programs have improved the detection rate of very small pulmonary lesions. As such, the management of this sub-centimetric and often sub-solid lesions has become quite challenging for clinicians, especially for choosing the most suitable diagnostic method. In clinical practice, to fulfill this diagnostic yield, transthoracic needle biopsy (TTNB) is often the first choice especially for peripheral nodules. For lesions for which TTNB could present technical difficulties or failed, other diagnostic strategies are needed. In this case, video-assisted thoracic surgery (VATS) is the gold standard to reach the diagnosis of lung nodules suspect of being malignant. Nonetheless it’s often not easy the identification of such lesions during VATS because of their little dimensions, non-firm consistency, deep localization. In literature various marking techniques have been described, in order to improve intraoperative nodules detection and to reduce conversion rate to thoracotomy: CT-guided hookwire positioning, methylene blue staining, intra-operative ultrasound and electromagnetic navigation bronchoscopy are the most used. The scientific evidence on this matter is weak because there are no randomized clinical trials but only case series on single techniques with no comparison on efficacy, so there are no guidelines to refer. From this standing, in this article we conducted a narrative review of the existing literature on the subject, with the aim of outlining a framework as complete as possible. We analyzed strengths and weaknesses of the main techniques reported, so as to allow the clinician to orient himself with greater ease. AME Publishing Company 2021-04 /pmc/articles/PMC8107557/ /pubmed/34012598 http://dx.doi.org/10.21037/jtd-20-1712 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article
Imperatori, Andrea
Nardecchia, Elisa
Cattoni, Maria
Mohamed, Shehab
Di Natale, Davide
Righi, Ilaria
Mendogni, Paolo
Diotti, Cristina
Rotolo, Nicola
Dominioni, Lorenzo
Rosso, Lorenzo
Perioperative identifications of non-palpable pulmonary nodules: a narrative review
title Perioperative identifications of non-palpable pulmonary nodules: a narrative review
title_full Perioperative identifications of non-palpable pulmonary nodules: a narrative review
title_fullStr Perioperative identifications of non-palpable pulmonary nodules: a narrative review
title_full_unstemmed Perioperative identifications of non-palpable pulmonary nodules: a narrative review
title_short Perioperative identifications of non-palpable pulmonary nodules: a narrative review
title_sort perioperative identifications of non-palpable pulmonary nodules: a narrative review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107557/
https://www.ncbi.nlm.nih.gov/pubmed/34012598
http://dx.doi.org/10.21037/jtd-20-1712
work_keys_str_mv AT imperatoriandrea perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT nardecchiaelisa perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT cattonimaria perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT mohamedshehab perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT dinataledavide perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT righiilaria perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT mendognipaolo perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT diotticristina perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT rotolonicola perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT dominionilorenzo perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview
AT rossolorenzo perioperativeidentificationsofnonpalpablepulmonarynodulesanarrativereview