Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study

Liu, Li; Zhang, Long Jiang; Chen, Bin; Cao, Jian; Lu, Guang Ming; Yuan, Lei; Li, Kai; Xu, Junyi

doi:10.1177/0284185113506136

Cited by 46 publications

(43 citation statements)

References 21 publications

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“…Similar findings have been recently published for the technique of pre-operative CT-guided microcoil placement and resection with or without intraoperative fluoroscopy (8)(9)(10). Successful use of embolization coils has also been reported in several small series (11)(12)(13), Similar techniques have been described, with pre-operative CT-guided insertion of radiopaque markers attached to sutures that lie on the surface of the lung (14,15), placement of metallic clips (16), fragmented coils (17). One series describes intentional creation of a pneumothorax during the coil placement, by inserted a pigtail catheter to instil air into the pleural space.…”

Section: Discussionmentioning

confidence: 89%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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Background: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface.Methods: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014.Results: A total of 63 patients were included (37% male, mean age 61.6±11.4 years). Forty-two patients (67%) had a history of smoking, with 10 current smokers. Sixty one (97%) patients underwent wedge resection and 3 (5%) patients had segmentectomy. Three (5%) patients required intra-operative staple line re-resection for positive or close margins. Eleven (17%) patients had a completion lobectomy, 5 of which were during the same anaesthetic. The average time between the CT-guided insertion and start of operation was 136.6±89.0 min, and average operative time was 84.0±53.3 min. The intra-operative complication rate was 5% (n=3), including 1 episode of hemoptysis, and 2 conversions to thoracotomy. The post-operative complication rate was 8% (5 patients), and included 2 air leaks, 1 hemothorax (drop in hemoglobin), 1 post chest tube removal pneumothorax, and one venous infarction of the lingula after lingula-sparing lobectomy requiring completion lobectomy. . Average post-operative length of stay was 2.2 days. A diagnosis was made for all patients.Conclusions: CT-guided microcoil insertion followed by VATS lobectomy is safe, with short operative times, short length of stay and 100% diagnosis of small pulmonary nodules. This technique will become more important in the future with increasing numbers of small nodules detected on CT as part of lung cancer screening programs.

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Section: Discussionmentioning

confidence: 89%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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“…Second, the time needed for CT‐guided mark placement can be reduced. Third, there are no risks of puncture‐related complications such as pneumothorax, parenchymal hemorrhage, and even pulmonary embolism . Fourth, this may provide a backup option in cases of mark displacement.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, this approach provides a backup method in cases of mark displacement. Several methods, including hookwire, microcoil, dye injection, and radiotracer location [1][2][3][4][5] have been developed to facilitate recognition and location. Despite all of these methods, subjective onsite judgment and resection occasionally occurs, and therefore, has forced us to depict the target area incidentally.…”

Section: Funding Information Science and Technology Commission Of Shamentioning

confidence: 99%

“…Among all the available techniques, a majority require specific instruments, such as, hookwires and microcoils 1,4,5. Although these instruments provide an accurate location, their limitations are obvious: previous techniques are also instrument dependent and at a high risk (21.1-45.4%) of complications 1,4,5. In clinical practice, location with radiological information has been the first barrier prior to resection.Usually, surgeons utilize anatomic landmarks on the body surface (such as, scapular line, midaxillary line, and midclavicular line) to delineate the longitudinal position.…”

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confidence: 99%

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Technique of skeletal navigation for localizing solitary pulmonary nodules

Mao

Shi

Chen

et al. 2017

Journal of Surgical Oncology

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We herein detail a novel method of skeletal navigation for localizing small solitary pulmonary nodules of 8-30 mm size and at a distance of less than 15 mm from visceral pleura. Thirty-four lesions found in 29 patients were successfully localized. All 34 target nodules first underwent wedge resections, and there were no cases of technical failure of the present method. This technique incurs no additional cost and complications as caused by other localization approaches. Additionally, this approach provides a backup method in cases of mark displacement.

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“…A number of pulmonary nodule localization methods have been used, including barium, lipiodol, hook wire, Tc‐99m radionuclide, intraoperative ultrasonography, and metallic coil marking . Hook wire localization is probably the oldest method for VATS .…”

Section: Introductionmentioning

confidence: 99%

Comparison of hook wire versus coil localization for video‐assisted thoracoscopic surgery

2018

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BackgroundA hook wire has been most widely used for computed tomography (CT)‐guided localization before video‐assisted thoracoscopic surgery (VATS). However, microcoils have been suggested to replace wires. The purpose of this study was to compare the efficacy, VATS procedure time, and excised volume of specimens of CT‐guided localization using a hook wire and microcoil.MethodsThe medical records of 106 patients with 110 pulmonary nodules who underwent CT‐guided localization using a hook wire (group A) or microcoil (group B) before VATS performed between March 2013 and January 2017 were retrospectively reviewed.ResultsThe procedure success rate was 100% in both groups. Dislodgement occurred in four patients in group A and not in group B. Patient pain score was significantly lower for group B than group A (4.0 vs. 6.3; P < 0.001). The VATS success rate was higher in group B than in group A (98.1% vs. 91.1%; P = 0.174). The VATS procedure time was significantly shorter for group B than group A (18.8 vs. 23.6 minutes; P = 0.004). The excised volume of surgical specimens was significantly smaller for group B than group A (8.5 vs. 11.7 cm3; P = 0.043). No major complications related to the localization procedure were noted in either group.ConclusionsThis study showed similar effectiveness of VATS localization between groups. However, microcoil is superior to hook wire for localization of pulmonary nodules in terms of VATS procedure time and excised volume of surgical specimens, with the advantages of no dislodgement and less patient pain.

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Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study

Abstract: Preoperative localization of small peripheral pulmonary nodules using CT-guided embolization coil insertion and subsequent fluoroscopically-guided VATS resection is safer and more effective than conventional VATS.

Cited by 46 publications

References 21 publications

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

Technique of skeletal navigation for localizing solitary pulmonary nodules

Comparison of hook wire versus coil localization for video‐assisted thoracoscopic surgery

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