Remedial localization after dislodgement of primary mechanical localization in lung surgery

Wang, Long; Zhang, Xufeng; Mu, Li; Kadeer, Xiermaimaiti; Dai, Chenyang; Shi, Zhe; Chen, Chang

doi:10.21037/jtd.2017.04.61

Cited by 6 publications

(4 citation statements)

References 25 publications

(39 reference statements)

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“…Two types of localisations can be tried simultaneously. 29 Though multiple percutaneous puncture produced a signi cantly higher incidence of pneumothorax and hemorrhage,the localizations were clinically feasible and safe. 30,31 Lung nodules can be localised during surgery after every effort is exerted before operation.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Small Pulmonary Nodule Localisation Using Hookwires or Coils: Strategy Selection in Adverse Events

Zuo¹,

Gao²,

Wen³

et al. 2021

Preprint

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Objective We conducted a retrospective study of adverse events associated with the preoperative procedure of computed tomography (CT)–guided hookwire or coil localisation. We analysed the experience of and process flaws in resecting ground-glass nodules (GGNs) using video-assisted thoracoscopic surgery (VATS) and determined the remedial strategy. Methods Adverse events were evaluated in 20 patients with 25 GGNs who underwent CT-guided hookwire or coil localisation before VATS. For lesions not successfully marked or detected, palpation, resection of the highly suspected area, segmentectomy or lobectomy was performed. Results Among all adverse events, 10 were dislodgement of the marking materials, 2 were breakaway of the marking materials, 4 were >2-cm distance between the lesions and the tip, one was marking material across the two adjacent lobes, 10 were pneumothorax and two were certain parts of marking materials stuck into the walls. All GGNs were resected successfully. Fifteen lesions were detected by palpation. Three GGNs were discovered after the resection of highly suspected areas. The GGNs were removed by lobectomy. Segmentectomies and lobectomies were performed directly on two and four GGNs, respectively. Conclusions When adverse events occur, a second localisation, intraoperative localisation, resection of a highly suspected area, or a segmentectomy or lobectomy can be successfully attempted using VATS for resection of GGNs.

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Section: Discussionmentioning

confidence: 99%

Preoperative Small Pulmonary Nodule Localisation Using Hookwires or Coils: Strategy Selection in Adverse Events

Zuo¹,

Gao²,

Wen³

et al. 2021

Preprint

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“…CT-guided preoperative localization is widely performed in clinical practice because of its technical maturity, simple operating procedure, short time-cost, and high success rate. However, its application has limitations and risks, including severe pain, hemorrhage, hemopneumothorax, needle track tumor implantation (6), and markers displacement (7). Besides, some localizations are challenging due to anatomical issues like those next to the great vessels or beneath the scapula and sternum.…”

Section: Existing Techniques For Localization Of Pulmonary Nodulesmentioning

confidence: 99%

Application of indocyanine green injection guided by electromagnetic navigation bronchoscopy in localization of pulmonary nodules

Zhang¹,

He²,

Chen³

et al. 2021

Transl Lung Cancer Res

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Background: Accurate localization of pulmonary nodules becomes a crucial step in diagnosis and treatment. However, the efficacy and accuracy of electromagnetic navigation bronchoscopy (ENB)-guided localization with indocyanine green (ICG) injection for video-assisted thoracoscopic surgery (VATS) lung resection remain unclear.Methods: A retrospective study was performed that patients who had small pulmonary nodules and underwent lung resection after ENB-guided localization were included from Oct 2018 to Mar 2021. The analysis of the efficacy and accuracy of ENB-guided localization was conducted.Results: A total of 181 pulmonary nodules in 173 patients were recorded which were 9.21±4.81 mm in size.The mean time of ENB-guided localization was 7.99±4.9 minutes. The success rate of nodule localization was 98.3% (178/181), while the accuracy was 89% (161/181) without any complication. All patients received thoracoscopic surgery after localization, and all nodules were completely resected. A customized scoring system was used to evaluate localization accuracy, and the patients were divided into four groups according to it. The localization accuracy was positively associated with the bronchus sign (P<0.001) and negatively with the location of the nodule (anterior segment and superior lingual segment of left upper lobe) (P=0.013 and 0.03, respectively).Conclusions: ENB-guided pulmonary nodule localization by ICG injection is an accurate and effective method with a short operation time and few complications, which could be widely used in clinical practice.

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“…However, previous studies reveal the challenges encountered by the surgeon in performing VATS, including difficulty in locating pulmonary nodules quickly and accurately during surgery, especially for ground-glass nodules with small size, deep location, and few solid components [ 9 ]. Studies have shown that it is difficult to locate more than half of the nodules accurately in VATS; thus, thoracotomy is needed [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

CT-guided placement of microcoil end in the pleural cavity for video-assisted thoracic surgical resection of ground-glass opacity: a retrospective study

An¹,

Dong²,

et al. 2022

J Cardiothorac Surg

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Background The aim of the study was to investigate and summarize the effectiveness and safety of CT-guided microcoil localization before video-assisted thoracic surgery (VATS) for the removal of ground-glass opacity (GGO). Methods A total of 147 patients with GGO who were treated at our hospital between January 2019 and February 2021 were retrospectively analyzed. They were divided into two groups according to the final position at the end of the microcoil: intracavity (n = 78) and extracavity (n = 69), which were compared based on puncture complications and influence of the coil end position on VATS. Results The proportions of supine and prone positions in the intracavity group were significantly higher than those in the extracavity group (82.1% vs. 66.7%, P < 0.05). The incidence of intrapulmonary hemorrhage, chest pain, and coil displacement in the intracavity group was significantly lower than that in the extracavity group (28.2% vs. 46.4%, 19.2% vs. 39.1%, 1.3% vs. 11.6%, P < 0.05, respectively); however, the incidence of pneumothorax was not significantly different (P > 0.05). The time of VATS and the rate of conversion to thoracotomy in the intracavity group were significantly lower than those in the extracavity group (103.4 ± 21.0 min vs. 112.2 ± 17.3 min, 0% vs. 5.8%, P < 0.05, respectively). Conclusion CT-guided placement of the microcoil is a practical, simple, and convenient localization method before VATS, with a high success rate and few complications. Furthermore, it is a better alternative method to place the end of the coil in the pleural cavity because of the lower complication rate, shorter VATS time, and lower rate of thoracotomy conversion.

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Remedial localization after dislodgement of primary mechanical localization in lung surgery

Cited by 6 publications

References 25 publications

Preoperative Small Pulmonary Nodule Localisation Using Hookwires or Coils: Strategy Selection in Adverse Events

Preoperative Small Pulmonary Nodule Localisation Using Hookwires or Coils: Strategy Selection in Adverse Events

Application of indocyanine green injection guided by electromagnetic navigation bronchoscopy in localization of pulmonary nodules

CT-guided placement of microcoil end in the pleural cavity for video-assisted thoracic surgical resection of ground-glass opacity: a retrospective study

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