{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:46:35Z","timestamp":1791827195459,"version":"4.3.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Thoracoscopic resection of pulmonary metastases offers a minimally-invasive approach but requires preoperative localization due to absent tactile feedback. CT-guided methylene blue staining (MBS) was implemented to facilitate resection of pulmonary metastases, including intermediate-to-deep lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed pediatric patients (0\u201318 years) undergoing resection of pulmonary metastases (2007\u20132024). Lesion depth was classified as superficial (\u2264\u200910\u00a0mm), intermediate (11\u201320\u00a0mm), or deep (&gt;\u200920\u00a0mm). Primary endpoint was completeness of resection; secondary endpoints included perioperative and oncological outcomes. Subgroup analysis included patients with \u2264\u20092 pulmonary metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-eight resections in 43 patients were included: 49 open, and 9 thoracoscopic following CT-guided MBS. Eleven lesions were stained prior to thoracoscopic resection: three superficial, seven intermediate, one deep lesion. All were resected with negative margins, without complications. Thoracoscopy following CT-guided MBS was associated with shorter operative times (65 vs. 157\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), hospital stay (4.0 vs. 5.6 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and time-to-chemotherapy-resumption (2.25 vs. 18.6 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). No differences were observed in pulmonary recurrence, disease-free interval, or six-month-survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In pediatric patients with up to two pulmonary metastases, CT-guided methylene blue staining provided feasible preoperative localization, facilitating thoracoscopic wedge resection of superficial, intermediate and deep lesions without complications. Prospective multicenter studies should further evaluate efficacy and inclusion criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06675-1","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:06:42Z","timestamp":1791824802000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CT-guided methylene blue staining to facilitate thoracoscopic resection of intermediate-to-deep pulmonary metastases in pediatric patients"],"prefix":"10.1007","volume":"42","author":[{"given":"Mikal","family":"Obed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Wennemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Linderkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Pauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoen-oh","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Vogel-Claussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Dingemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3082-361X","authenticated-orcid":false,"given":"Rim","family":"Kiblawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"6675_CR1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3390\/children6010006","volume":"6","author":"NJ Croteau","year":"2019","unstructured":"Croteau NJ, Heaton TE (2019) Pulmonary Metastasectomy in Pediatric Solid Tumors. 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