CT-guided Microcoil Pulmonary Nodule Localization prior to Video-assisted Thoracoscopic Surgery: Diagnostic Utility and Recurrence-Free Survival

Abstract

ung cancer is the leading cause of cancer-related mortality globally (1). Staging and surgical methods have evolved since the Lung Cancer Study Group randomized trial more than 2 decades ago (2). There is controversy regarding the best surgical approach for early-stage lung cancer. A metaanalysis of 12 studies and 1078 patients revealed similar long-term survival outcomes for lobectomy and intentional sublobar resection (in patients eligible for lobectomy) for small, peripheral non-small cell lung cancer (NSCLC) (3). Although sublobar resection has a higher risk of positive resection margins (4) and local recurrence (5), these complications may be salvaged with curative intent. In surgical candidates, NSCLC stage IA tumors should be resected with adequate margins. Preoperative nodule localization techniques such as the CTguided microcoil have the potential to achieve this goal. CT-guided microcoil localization is safe and effective in aiding the resection of nonpalpable (6,7) and small peripheral (8-10) nodules with adequate resection margins (11). It has been shown to reduce the need for thoracotomy or video-assisted thoracoscopic surgery (VATS) anatomic resection in a prospective randomized controlled trial (12), with shorter operative time and length of stay compared with lobectomy

CT-Guided Microcoil Localization of Small Peripheral Pulmonary Nodules to Direct Video-Assisted Thoracoscopic Resection without the Aid of Intraoperative Fluoroscopy

“…Accurate and effective preoperative or intraoperative localization techniques are helpful for successful wedge resection using VATS. Different materials have been used for the preoperative localization of SPNs [ 11 12 13 14 15 16 17 18 19 ]. Microcoils are relatively ideal for preoperative localization of SPNs.…”

Percutaneous Microcoil Localization of a Small, Totally Endophytic Renal Mass for Nephron-Sparing Surgery: A Case Report and Literature Review

“…There have been few published reports on the usefulness, e cacy and safety of the microcoil localization of tumours in nephron-sparing surgery. Evidence from video-assisted thoracic surgery suggests that microcoil localization is an effective and useful technique [11][12][13][14]. The patient in our report received an acceptable radiation dosage and experienced no discomfort.…”

Application of Modified Tailed Microcoil in Preoperative Localization of Small Pulmonary Nodules: A Retrospective Study

“…Rodrigues et al demonstrated that VATS and CT-guided microcoil localization was associated with excellent recurrence-free survival for superficial premalignant, minimally invasive, and small invasive lung tumors. 9 In the past, the examination of pulmonary nodules relied mainly on needle biopsy, bronchoscopy, positron emission tomography-CT, and so on, but the diagnostic accuracy was still not satisfied. 10 For the diagnosis of peripheral SNPs by VATS resection, microcoil with methylene blue localization has been proved as a useful technique.…”