Preoperative short hookwire placement for small pulmonary lesions: evaluation of technical success and risk factors for initial placement failure

Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Masaoka, Yoshihisa; Tsuruo, Takashi; Sato, Takuya; Gobara, Hideo; Toyooka, Shinichi; Kanazawa, Susumu

doi:10.1007/s00330-017-5176-2

Cited by 14 publications

(15 citation statements)

References 20 publications

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“…Thoracic computed tomography (CT) is commonly used to detect lung nodules, [1][2][3][4][5][6] with some patients presenting with multiple lung nodules (MLNs) that can correspond to metastatic lesions or to multiple primary lung cancers. [7][8][9] When possible, a video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection approach has been employed to remove these MLNs from patients, as this procedure is less invasive and removes less healthy tissue than do other lobectomy-based resection strategies.…”

Section: Introductionmentioning

confidence: 99%

Preoperative computed tomography-guided coil localization for multiple lung nodules

Teng

Yang

et al. 2020

Ther Adv Respir Dis

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Background: Preoperative computed tomography (CT)-guided coil localization can increase the technical success of video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection of lung nodules relative to cases treated without localization. When multiple lung nodules (MLNs) are to be resected, preoperative localization for each lung nodule is required. The aim of this study was to explore the feasibility, safety, and clinical efficacy of preoperative CT-guided coil localization of MLNs. Methods: Between November 2015 and July 2019, 31 patients with MLNs were assessed via CT-guided coil localization followed by VATS-guided wedge resection. Rates of technical success for both the localization and wedge resection procedures, as well as data pertaining to patient complication rates and long-term outcomes were recorded and assessed. Results: In total, 68 nodules (average of 2.2 nodules/patient) were localized and resected using this approach. Nodules were unilateral and bilateral in 23 and 8 patients, respectively. The rate of CT-guided coil localization technical success for these nodules was 98.5% (67/68), with a technical success rate of single-stage coil localization on a per-patient basis of 96.8% (30/31). Following localization, asymptomatic pneumothorax occurred in four patients (12.9%). The wedge resection technical success rate was 100%. Mean VATS operative time was 167.3 ± 75.2 min, with a mean blood loss of 92.6 ± 61.5 ml. Patients were followed between 3 and 46 months (median: 24 months), with no evidence of new nodules, distant metastases, or postoperative complications in any patients. Conclusion: Preoperative CT-guided multiple coil localization can be easily and safely used to guide single-stage VATS diagnostic wedge resection in patients with MLNs. The reviews of this paper are available via the supplemental material section.

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Section: Introductionmentioning

confidence: 99%

Preoperative computed tomography-guided coil localization for multiple lung nodules

Teng

Yang

et al. 2020

Ther Adv Respir Dis

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“…To [21,[45][46][47][48] localize small lung tumors, an intraoperatively identified marker can be placed under the guidance of a CT scan. Markers that have been used for this technique include a hookwire [42][43][44], microcoils [21,[45][46][47][48], dyes [49][50][51][52], contrast media [53][54][55], and radioisotopes [56,57]. Technical limitations of CT-guided percutaneous marking include marking for tumors in specific locations, such as the apex; the posterior subpleural area just medial to the scapula; the deep area, including the hilum and the center of the lobes; the area in close proximity to the great vessels; and the subpleural area adjacent to the diaphragm.…”

Section: Computed Tomography-guided Percutaneous Marker Placementmentioning

confidence: 99%

“…Intraoperatively, the extrapleural extension of the wire or string attached to the wire can be easily identified through thoracoscopy; in most cases, no additional modalities for localization, such as fluoroscopy, are required, which is one of the advantages of this procedure. Although the most common complication associated with a hookwire procedure is dislodgement or migration of the hookwire after placement [42], this procedure is also associated with the risk of other complications, as described above. In particular, air embolism has been reported to occur almost exclusively following hookwire placement [73][74][75].…”

Section: Computed Tomography-guided Percutaneous Marker Placementmentioning

confidence: 99%

Technical Advances in Segmentectomy for Lung Cancer: A Minimally Invasive Strategy for Deep, Small, and Impalpable Tumors

Eguchi

Satô

Shimizu

2021

Cancers

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With the increased detection of early-stage lung cancer and the technical advancement of minimally invasive surgery (MIS) in the field of thoracic surgery, lung segmentectomy using MIS, including video- and robot-assisted thoracic surgery, has been widely adopted. However, lung segmentectomy can be technically challenging for thoracic surgeons due to (1) complex segmental and subsegmental anatomy with frequent anomalies, and (2) difficulty in localizing deep, small, and impalpable tumors, leading to difficulty in obtaining adequate margins. In this review, we summarize the published evidence and discuss key issues related to MIS segmentectomy, focusing on preoperative planning/simulation and intraoperative tumor localization. We also demonstrate two of our techniques: (1) three-dimensional computed tomography (3DCT)-based resection planning using a novel 3DCT processing software, and (2) tumor localization using a novel radiofrequency identification technology.

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“…Additionally, dislodgement of the lung markers remains a challenge. Although less common with microcoils, several papers have identified risk factors for dislodgement that are all tied to motion in some form (24, 25). Hence, additional movement associated with breathing pattern and patient transport add to this risk.…”

Section: Benefits and Limitations Of The Hybrid Room Approachmentioning

confidence: 99%

Value of the Hybrid Operating Theater for an Integrated Approach to Diagnosis and Treatment of Pulmonary Nodules in 2019

et al. 2019

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Preoperative short hookwire placement for small pulmonary lesions: evaluation of technical success and risk factors for initial placement failure

Cited by 14 publications

References 20 publications

Preoperative computed tomography-guided coil localization for multiple lung nodules

Preoperative computed tomography-guided coil localization for multiple lung nodules

Technical Advances in Segmentectomy for Lung Cancer: A Minimally Invasive Strategy for Deep, Small, and Impalpable Tumors

Value of the Hybrid Operating Theater for an Integrated Approach to Diagnosis and Treatment of Pulmonary Nodules in 2019

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