Computed tomography‐guided hook wire localization facilitates video‐assisted thoracoscopic surgery of pulmonary ground‐glass nodules

Abstract

BackgroundThis retrospectively study was conducted to assess the efficiency and safety of computed tomography (CT)‐guided hook wire localization of pulmonary ground‐glass nodules (GGNs) prior to video‐assisted thoracoscopic surgery (VATS).MethodsFrom 2015 to 2018, a total of 86 patients with 86 pulmonary GGNs underwent preoperative CT‐guided hook wire localization before VATS. The technical details and clinicopathological findings were analyzed.ResultsAll 86 pulmonary GGNs (25 pure GGNs and 61 part‐solid GGNs) were successfully located and resected. The mean diameter of the GGNs was 1.4 ± 0.4 cm (range 0.6–2.2) and the mean lesion distance to the pleural surface was 7.3 ± 4.3 mm (range 2–19). Complications of hook wire marking included asymptomatic minor pneumothorax in 21 patients (24%) and focal pulmonary hemorrhage in 18 (21%). The median hook wire localization time was 19.1 minutes (range 10–30) and the median VATS time was 49 minutes (range 28–89). Pathology revealed 72 precancerous lesions or primary lung adenocarcinomas, 5 metastatic tumors, and 9 benign lesions.ConclusionsPreoperative localization of small pulmonary GGNs using CT‐guided hook wire was efficient and safe prior to VATS resection.

Computed tomography‐guided coil localization for video‐assisted thoracoscopic surgery of sub‐solid lung nodules: a retrospective study

“…Most sub‐solid lung nodules tend to correspond to early‐stage lung cancer or precancerous lesions . Surgical resection may provide nearly 100% disease‐free survival for patients with sub‐solid lung nodules . Although the Fleischner Society has provided a detailed follow‐up protocol for sub‐solid lung nodules, this process can be mentally distressing for patients.…”

Ultralow dose computed tomography protocol for hook‐wire localization of solitary pulmonary nodules prior to video‐assisted thoracoscopic surgery

“…Klinkenberg et al reported one case (0.7%) and Chen et al reported two cases (4.9%) of dislodgement in their studies As discussed in our former study, many effective measures are taken to prevent dislodgement . In terms of other complications, pneumothorax is the most common, with a reported incidence of 7.5–40% .…”

“…10,19 As discussed in our former study, many effective measures are taken to prevent dislodgement. 11 In terms of other complications, pneumothorax is the most common, 20 with a reported incidence of 7.5-40%. 15 In our cohort, asymptomatic minimal pneumothorax in 24 patients (27.3%) did not require further intervention.…”

“…Hook‐wire localization (HWL) is currently the most commonly used technique for small lung nodule localization prior to video‐assisted thoracoscopic surgery (VATS) . Presurgical localization of unpalpable nodules can precisely guide surgeons, whereas repetitive CT scanning was previously necessary.…”

“…8,9 Hook-wire localization (HWL) is currently the most commonly used technique for small lung nodule localization prior to video-assisted thoracoscopic surgery (VATS). 10,11 Presurgical localization of unpalpable nodules can precisely guide surgeons, whereas repetitive CT scanning was previously necessary. The procedure-related radiation dose should be taken into account and should be as low as reasonably achievable; 12 however, relatively few studies have described the use of ultralow or low dose CT protocols for CT-guided HWL.…”