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Video-assisted thoracic surgery ultrasound (VATS-US) in the evaluation of subpleural disease: preliminary report of a systematic study

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Abstract

We provide a pictorial essay examining the preliminary data of an ongoing study whose primary aim is to assess the usefulness and safety of video-assisted thoracic surgery ultrasound (VATS-US) in the identification of different lung diseases. We studied 14 patients (five women and nine men with a mean age of 56.2 ± 8.4 SD years) with indication for VATS. All patients underwent pre-operative imaging of the chest using high-resolution computed-tomography, contrast-enhanced computed-tomography, and/or positron emission tomography and transthoracic ultrasound. VATS-US was performed under general anesthesia with single-lung ventilation through double-lumen endotracheal intubation in all patients, and the Esaote MyLab 25 laparoscope probe with flexible tip and a linear array transducer at frequencies 8.0–12.0 MHz was used. The final histological diagnoses in our cohort were cancer (three cases), usual interstitial pneumonia (five cases), nonspecific interstitial pneumonia (two cases), and hypersensitivity pneumonitis (one case). In patients with pulmonary fibrosis, the VATS-US showed a thick hyperechoic pleural line and no B-lines. Regarding cancer nodules, the VATS-US images showed a uniform hypoechogenic pattern with jagged margins. In patients with hamartochondroma and histocytosis X, VATS-US showed a mixed hyperechoic structure of the margins. In conclusion, we described the US semeiotics of various lung disorders assessed during VATS by reporting the preliminary data of the first study which applies the methodology systematically to all patients undergoing the surgery procedure. Final results from the study will further elucidate how the technique could be of use during the VATS procedure.

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Authors and Affiliations

  1. Interventional Ultrasound Unit of Internal Medicine, IRCCS Fondazione Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy

    Marco Sperandeo

  2. Unit of Thoracic Surgery, IRCCS Fondazione Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy

    Elisabettamaria Frongillo & Marco Taurchini

  3. Unit of Pathology, IRCCS Fondazione Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy

    Lucia Maria Cecilia Dimitri

  4. Department of Radiology, IRCCS Fondazione Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy

    Anna Simeone

  5. Unit of Internal Medicine, IRCCS Fondazione Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy

    Salvatore De Cosmo

  6. Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy

    Cristiana Cipriani

Authors
  1. Marco Sperandeo
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  2. Elisabettamaria Frongillo
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  3. Lucia Maria Cecilia Dimitri
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  4. Anna Simeone
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  5. Salvatore De Cosmo
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  6. Marco Taurchini
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  7. Cristiana Cipriani
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Correspondence to Marco Sperandeo.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and later amendments or comparable ethical standards.

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Sperandeo, M., Frongillo, E., Dimitri, L.M.C. et al. Video-assisted thoracic surgery ultrasound (VATS-US) in the evaluation of subpleural disease: preliminary report of a systematic study. J Ultrasound 23, 105–112 (2020). https://doi.org/10.1007/s40477-019-00374-5

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  • DOI: https://doi.org/10.1007/s40477-019-00374-5

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