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. 2023 Apr 5;18(1):99.
doi: 10.1186/s13019-023-02188-3.

Application of computed tomography-guided hook-wire localization technique in thoracoscopic surgery for small pulmonary nodules (≤ 10 mm)

Yuan Yang  1 , Chenhui Qin  1 , Yue Ma  1 , Zhongting Lu  1 , Yun Zhang  1 , Tao Li  2
Affiliations

Application of computed tomography-guided hook-wire localization technique in thoracoscopic surgery for small pulmonary nodules (≤ 10 mm)

Yuan Yang et al. J Cardiothorac Surg. .

Abstract

Objective: This study aimed to investigate the safety and efficacy of the computed tomography (CT)-guided hook-wire localization technique in thoracoscopic surgery for small pulmonary nodules (≤ 10 mm) and to identify the risk factors for localization-related complications.

Methods: The medical records of 150 patients with small pulmonary nodules treated from January 2018 to June 2021 were retrospectively analyzed. According to preoperative hook-wire positioning status, they were divided into the localization group (50 cases) or the control group (100 cases). The operation time, intraoperative blood loss, hospital stay, and conversion rate to thoracotomy were recorded and compared between groups. Uni- and multivariate binary logistic regression analysis was used to identify the risk factors for localization-related complications.

Results: A total of 58 nodules were localized in 50 patients in the localization group, and the localization success rate was 98.3% (57/58). In one case, the positioning pin fell off before wedge resection was performed. The mean nodule diameter was 7.05 mm (range, 2.8-10.0 mm), while the mean depth from the pleura was 22.40 mm (range, 5.47-79.47 mm). There were 8 cases (16%) of asymptomatic pneumothorax, 2 (4%) of intrapulmonary hemorrhage, and 1 (2%) of pleural reaction.The mean operation time of the localization group (103.88 ± 41.74 min) was significantly shorter than that of the control group (133.30 ± 45.42 min) (P < 0.05). The mean intraoperative blood loss of the localization group (44.20 ± 34.17 mL) was significantly lower than that of the control group (112.30 ± 219.90 mL) (P < 0.05). The mean hospital stay of the localization group (7.96 ± 2.34 days) was significantly shorter than that of the control group (9.21 ± 3.25 days).Multivariate binary logistic analysis showed that localization times of small pulmonary nodules in the localization group was an independent risk factor for localization-related pneumothorax.

Conclusions: Our results suggest that the CT-guided hook-wire localization technique is beneficial for localizing small pulmonary nodules. Specifically, it is helpful for the diagnosis and treatment of early lung cancer because it can accurately remove lesions, decrease intraoperative blood loss, shorten operation time and hospitalization stay, and reduce thoracotomy conversion rate. Simultaneous positioning of multiple nodules can easily lead to positioning-related pneumothorax.

Keywords: CT guidance; Hook-wire localization; Pulmonary nodules; Thoracoscopic surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic of the disposable pulmonary nodule locating needle. a Plastic sleeve and buckle; b Puncture needle; c Positioning line and anchor needle; d Push tube
Fig. 2
Fig. 2
A The lesion with the maximum diameter. B Computed tomography (CT) scan to determine the accuracy of the locating needle’s position. C Repeat CT scan to confirm the location of the anchor needle. D The image under thoracoscopy after hook-wire localization. E The lung tissue resected by wedge resection. F The locating needle is in the center of the lesion
See this image and copyright information in PMC

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References

    1. Aberle DR, Abtin F, Brown K. Computed tomography screening for lung cancer: has it finally arrived? Implications of the national lung screening trial. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31(8):1002–1008. doi: 10.1200/JCO.2012.43.3110. - DOI - PMC - PubMed
    1. Baldwin DR, Callister ME, Guideline Development Group The British thoracic society guidelines on the investigation and management of pulmonary nodules. Thorax. 2015;70(8):794–798. doi: 10.1136/thoraxjnl-2015-207221. - DOI - PubMed
    1. Lung Cancer Group of the Chinese Medical Association Respiratory, Expert Group of Chinese Alliance Against Lung Cancer. Chinese Expert Consensus on the Diagnosis and Treatment of Pulmonary Nodules (2018 Edition). Chinese Journal of Tuberculosis and Respiratory Diseases. 2018, 41(10):763–771.
    1. Wahidi Momen M, Govert Joseph A, Goudar Ranjit K, et al. Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines. Chest. 2007;132:94S–107S. doi: 10.1378/chest.07-1352. - DOI - PubMed
    1. Park CH, Han K, Hur J, Lee SM, Lee JW, Hwang SH, Seo JS, Lee KH, Kwon W, Kim TH, Choi BW. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: a systematic review and meta-analysis. Chest. 2017;151(2):316–328. doi: 10.1016/j.chest.2016.09.017. - DOI - PubMed

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