Computed tomography-guided coil localization for sub-fissural lung nodules

Abstract

This study was designed to explore the safety, feasibility, and clinical efficacy of preoperative computed tomography (CT)-guided coil localization of sub-fissural lung nodules (LNs). A total of 105 LN patients underwent CT-guided coil localization followed by video-assisted thoracoscopic surgery (VATS)-guided wedge resection at our hospital from January 2016 to December 2019. Of these patients, 4 had sub-fissural LNs and were therefore subjected to trans-fissural coil localization procedures. We analyzed data pertaining to the coil localization and VATS procedures in these patients. A total of 4 coils were used to localize 4 LNs in 4 separate patients. One of these patients suffered from parenchymal hemorrhage around the needle path, while one other patient exhibited asymptomatic pneumothorax following coil localization. A thoracoscope was able to successfully visualize the coil tails in all of these patients. There were no instances of coils having been dislodged, and wedge resection was conducted with a 100% technical success rate in these patients. These 4 LNs were subsequently diagnosed as adenocarcinomas in situ (n = 3) and benign nodules (n = 1). CT-guided coil localization can be used to safely and easily localize sub-fissural LNs in patients scheduled to undergo VATS.

Computed tomography-guided trans-pulmonary-hepatic approach coil localization for pulmonary nodules near the right lung base

“…Li et al [5] and Xia et al [7] performed CT-guided trans-fissural CL for patients with sub-fissural PNs with Computed tomography-guided trans-pulmonary-hepatic approach coil localization for pulmonary nodules near the right lung base both teams achieving 100% technical success. There are certain similarities between the CT-guided trans-fissural and trans-pulmonary-hepatic approach CL procedures.…”

“…With peripheral PNs, the coils are usually located at the peripheral pleura [1][2][3]. Recently, CL has been successfully used in difficult cases including multiple, sub-fissural, and scapula-blocked PNs [4][5][6]. Besides these, some patients have PNs near the base of the right lung.…”