Efficacy and Complications of Computed Tomography-Guided Hook Wire Localization

Ichinose, Junji; Kohno, Tadasu; Fujimori, Sakashi; Harano, Takashi; Suzuki, Souichiro

doi:10.1016/j.athoracsur.2013.05.026

Cited by 148 publications

(151 citation statements)

References 29 publications

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“…Kastl (8) hold the point that hook wires are easily dislodged, resulting in high failure rates. Some researchers have reported that dislodgement rate in VATS resection with CT-guided single hook wire localization ranging from 0.4-4.9% (22,24,25). Compared to other reviews, the dislodgement rate in doublethorn hook wire applied by Chen (26) is up to 7%, whose incidence is within the 8-20% range reported in the literature (27,28).…”

Section: Discussionmentioning

confidence: 73%

“…Studies have showed that pneumothorax and pulmonary hemorrhage, with an incidence of 32.1-68% and 10.3-36%, respectively, in preoperative hook wire placement (22,29,30). Ichinose and colleagues represented similar result, of 500 lesions underwent CT-guided localization, pneumothorax was observed in 49% of the patients immediately after location, only 4.6% require intervention (22), much higher than other study (apply double-thorn hook wire) reported (18.6% and 24.4%) (23). While the pneumothorax induced by double-thorn hook wire is lower than the single semi-rigid hook wire mentioned above.…”

Section: Discussionmentioning

confidence: 99%

“…The use of methylene blue may also be limited in patients with anthracotic swine mentation for it is difficult to see during VATS. While, hook wires, do not require intraoperative fluoroscopy to detect targets, perform better in resecting small pulmonary nodules via VATS for the short procedure time, precise wedge resection and a better intraoperative manipulation (lift up the lung for wedge resection) (9,10,12,13,22,23). Kastl (8) hold the point that hook wires are easily dislodged, resulting in high failure rates.…”

Section: Discussionmentioning

confidence: 99%

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Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

et al. 2017

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Background: The aim of this study was to compare the effects of currently available preoperative localization methods, including semi-rigid single hook-wire, double-thorn hook-wire, and microcoil, in localizing the pulmonary nodules, thus to select the best technology to assist video-assisted thoracoscopic surgery (VATS) for small ground glass opacities (GGO).Methods: Preoperative CT-guided localizing techniques including semi-rigid single hook-wire, doublethorn hook-wire and microcoil were used in re-aerated fresh swine lung for location experiments. The advantages and drawbacks of the three positioning technologies were compared, and then the most optimal technique was used in patients with GGO. Technical success and post-operative complications were used as primary endpoints.Results: All three localizing techniques were successfully performed in the re-aerated fresh swine lung.The median tractive force of semi-rigid single hook wire, double-thorn hook wire and microcoil were 6.5, 4.85 and 0.2 N, which measured by a spring dynamometer. The wound sizes in the superficial pleura, caused by unplugging the needles, were 2 mm in double-thorn hook wire, 1 mm in semi-rigid single hook and 1 mm in microcoil, respectively. In patients with GGOs, the semi-rigid hook wires localizations were successfully performed, without any complication that need to be intervened. Dislodgement was reported in one patient before VATS. No major complications related to the preoperative hook wire localization and VATS were observed. Conclusions:We found from our localization experiments in the swine lung that, among the commonly used three localization methods, semi-rigid hook wire showed the best operability and practicability than doublethorn hook wire and microcoil. Preoperative localization of small pulmonary nodules with single semi-rigid hook wire system shows a high success rate, acceptable utility and especially low dislodgement in VATS. IntroductionThe widespread application of low-dose computed tomography (LDCT) has led to a great increase in the identification rate of small pulmonary nodules, especially small ground glass opacities (GGO). GGO is defined as a hazy opacity that does not obscure underlying bronchial structures or pulmonary vessels on CT scans (1). It has been reported that 33-60% GGO was malignant carcinoma when the nodules size ranges from 11-20 mm, while the malignant rate increase to 64-82% when the size grows up greater than 20 mm (2). Although the identification of pulmonary nodules could be effectively accomplished by many imaging modalities, including high-resolution CT, positron emission tomography (PET/CT), and bronchoscopy, whereas the identification of lesions with GGO remains difficult. Thus, more reliable diagnosis and therapeutic options for uncertain pulmonary nodules are still in need (3).Video-assisted thoracoscopic surgery (VATS) is less invasive in diagnosing and treating thoracic lesions, thus how to locate and mark the nodules more precisely before the VATS becomes one of the most important ...

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

et al. 2017

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“…In our experience, of 500 procedures for 417 patients, systemic air embolism was the most serious complication, and it occurred in only 1 patient (0.24%), albeit without any sequelae and with spontaneous resolution. 21) This study has several limitations. The results were influenced by selection bias in several phases, including patient referral to the Department of Thoracic Surgery, surgical treatment selection, and the decision to perform PET.…”

Section: Discussionmentioning

confidence: 99%

Invasiveness and Malignant Potential of Pulmonary Lesions Presenting as Pure Ground-Glass Opacities

Ichinose

Kohno

Fujimori

et al. 2014

ATCS

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“…All of the invasive positioning techniques carry a risk of complications such as pneumothorax, chest pain, pulmonary hemorrhage, and cough, because pulmonary puncture needs to be performed (Ichinose et al, 2013;Nouri et al, 2013). It has been reported that the hook-wire positioning technique has multiple complications, particularly unhooking.…”

Section: Discussionmentioning

confidence: 99%

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Zhai

Guan

et al. 2015

Genet. Mol. Res.

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ABSTRACT.This study aimed to analyze the clinical application value of computed tomography (CT)-guided hook-wire positioning before thoracoscopic surgery. Eighty-four patients who had received a thoracoscopic wedge resection of pulmonary nodules between January and December 2013 were selected. Group A consisted of 38 cases where the hook-wire positioning technique was not used, and the positioning approaches were intraoperative observation and palpation. Group B consisted of 46 cases where the hook-wire positioning technique was used. The diameter of each nodule was less than 2 cm, and all patients underwent the operation within 2 h of invasive positioning. The evaluation indexes included positioning success rate, positioningrelated complications, and rate of conversion to thoracotomy. In Group A, nine patients (23.68%) underwent conversion to thoracotomy; in Group B, three patients (6.52%) did. This difference was statistically significant (P < 0.05). The average operation duration was 118 ± 21 min in Group A and 53 ± 18 min in Group B. The difference between both groups was statistically significant (P < 0.05). The average length 3799 Positioning of pulmonary nodules ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 3798-3806 (2015) of hospital stay of patients who underwent conversion to thoracotomy was 8.7 ± 2.2 days, and of patients who underwent thoracoscopic pulmonary wedge resection was 4.5 ± 1.6 days. This difference was statistically significant (P < 0.05). Therefore, CT-guided hook-wire positioning of pulmonary nodules before thoracoscopic surgery has clinical application value. It helps to accurately locate the pulmonary nodules, effectively lowers the rate of conversion to thoracotomy, and reduces the operation duration.

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Efficacy and Complications of Computed Tomography-Guided Hook Wire Localization

Cited by 148 publications

References 29 publications

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

Semi-rigid single hook localization the best method for localizing ground glass opacities during video-assisted thoracoscopic surgery: re-aerated swine lung experimental and primary clinical results

Invasiveness and Malignant Potential of Pulmonary Lesions Presenting as Pure Ground-Glass Opacities

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

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