TY - JOUR AU - Sato, Masaaki AU - Kuwata, Taiji AU - Kitamura, Atsushi AU - Misawa, Kenji AU - Imashimizu, Kota AU - Yamanashi, Keiji AU - Ikeda, Masaki AU - Koike, Terumoto AU - Kobayashi, Masashi AU - Kosaka, Shinji AU - Fukai, Ryuta AU - Isowa, Noritaka AU - Nagayama, Kazuhiro AU - Aoyama, Akihiro AU - Date, Hiroshi AU - Nakajima, Jun PY - 2018 TI - The role of virtual-assisted lung mapping in the resection of ground glass nodules JF - Journal of Thoracic Disease; Vol 10, No 5 (May 31, 2018): Journal of Thoracic Disease Y2 - 2018 KW - N2 - Background: Virtual-assisted lung mapping (VAL-MAP), a bronchoscopic multi-spot dye-marking technique, was tested for its ability to resect ground glass nodules (GGNs) in sublobar lung resections. Methods: All patients were prospectively registered in the multi-institutional lung mapping (MIL-MAP) study using VAL-MAP. The data were retrospectively analyzed, focusing on GGNs. GGN characteristics, pathological findings, operation type, and the surgical contribution of VAL-MAP were evaluated. Results: The 370 GGNs in 299 patients included 257 pure and 113 mixed GGNs. There were 146 wedge resections (43.6%), 99 simple segmentectomies (29.6%), and 60 complex segmentectomies (18.0%). The largest number of marks were used in complex segmentectomy (4.05±0.74), followed by simple segmentectomy (3.35±0.97) and wedge resection (2.96±0.80). The overall successful resection rate was 98.6%. Multiple [2–5] GGNs were concurrently targeted by VAL-MAP in 53 patients (17.7%) with 123 GGNs. Two concurrent resections were conducted in 36 patients (12.1%), most commonly wedge resection and segmentectomies (21 patients). Among 190 sub-centimeter GGNs, 24 out of 51 GGNs ≤5 mm in diameter (47.1%) and 113 of 139 GGNs >5 mm in diameter (81.3%) were primary lung cancer (P Conclusions: VAL-MAP enabled thoracoscopic limited resection of GGNs. Its multiple marks facilitated resections of multi-centric GGNs. Resected suspicious GGNs >5 mm in diameter are likely to be lung cancer. VAL-MAP may impact decision-making regarding the indications and type of surgery for suspicious small GGNs. UR - https://jtd.amegroups.org/article/view/21387