2020 Volume 56 Issue 6 Pages 982-987
The patient was an 11-year-old female who presented with osteosarcoma of the left femur. Before treatment, a 3-mm nodular shadow was observed in the right lung (S8). The patient was initially treated with a limb-sparing radical operation and adjuvant chemotherapy, but the lung mass did not disappear. As a result, surgery was indicated for diagnostic treatment. The operation was performed in a hybrid operating room. Cone beam computed tomography (CBCT) was performed before the thoracoscopic surgery, which indicated through which area the lesion could be reached in the shortest distance possible. Next, a 23G needle was inserted into the chest wall at the same site, and CBCT was performed again. After confirmation of the lesion’s location on the needle tip, the needle was advanced into the lung, and indocyanine green was subsequently injected locally. Thoracoscopic surgery was started, and CBCT was performed to provide a support thread and a clip on the marked lung tissue. After confirmation that the clip was sufficiently close to the lesion, the targeted area was resected. The lesions were found to be well contained within the resected tissue, and the postoperative course was satisfactory. No previous studies have shown the use of hybrid operating rooms to perform CBCT marking and thoracoscopic partial lung resection in children. This method seems to be an effective and viable option.
