Simultaneous Multiple Preoperative Localizations of Small Pulmonary Lesions Using a Short Hook Wire and Suture System

Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Sugimoto, Seiichiro; Toyooka, Shinichi; Oto, Takahiro; Miyoshi, Shinichiro; Kanazawa, Susumu

doi:10.1007/s00270-014-1028-5

Cited by 29 publications

(59 citation statements)

References 16 publications

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“…The lesion success rate in Group B was lower than that in a previous study (96.3%). It was because our definition of success was < 3 cm from lesions, and on another hand, our patients had 2.51 lesion on average, more than that in a previous study (2.28) . With respect to the success rate of every procedure, both groups successfully localized all first and second lesions.…”

Section: Discussionmentioning

confidence: 66%

“…Moreover, the procedures in our modified simultaneous technique are simple, thus operators could easily implement all of the procedures and save time. Moreover, it was also shorter than the previous study of 36.4 minutes . Thirdly, the modified technique can localize lesions more precisely.…”

Section: Discussionmentioning

confidence: 85%

“…The occurrence of pneumothorax limits localization of remaining small pulmonary nodules (SPNs). Additionally, multi‐lesion localization can lengthen the overall procedure time …”

Section: Introductionmentioning

confidence: 99%

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Modified hook‐wire placement technique for localizing multiple pulmonary nodules

Kadeer

Wang

Zhang

et al. 2018

Journal of Surgical Oncology

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Background The localization of multiple pulmonary nodules is challenging due to a high incidence of pneumothorax after each needle insertion into lung parenchyma. The aim of the current study is to verify the safety and effectiveness of a modified technique utilizing simultaneous Hookwire placement to localize multiple lesions. Methods The proposed method comprises a row of metal wires, perpendicular insertion, simultaneous release of Hookwire, and a lateral position to modify a conventional localizing technique. From January 2015 to August 2016, 23 patients were subjected to the modified technique group (Group A), while 53 patients in the conventional group (Group B). Success rates, procedural parameters, and complications were recorded and analyzed. Results Compared with Group B, Group A had higher success rate of lesion (96.7% vs 83.5%, P = 0.009), lower numbers of CT scans (2.91 vs 5.59, P < 0.001), shorter procedure duration (13.83 minutes vs 22.68 minutes, P < 0.001), and shorter distance between localizers and lesions (4.88 vs 6.29, P = 0.006). The incidence of pneumothorax in Group A was lower (21.8% vs 54.7%, P = 0.008), while lung hemorrhage was not significantly different ( P = 0.735). Lesion number and pneumothorax were risk factors for failure in multiple localizations. Conclusions The modified Hookwire placement technique was feasible and successful, which was associated with fewer computed tomography scans, shorter procedure duration, and a lower incidence of pneumothorax.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 85%

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Modified hook‐wire placement technique for localizing multiple pulmonary nodules

Kadeer

Wang

Zhang

et al. 2018

Journal of Surgical Oncology

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“…In addition, pathologists can easily find lesions in the resected lung tissues guided by the localized marks . Hook‐wire has been widely used for this preoperative localization . However, dislodgement rates are rather high, up to 16% in some reports .…”

Section: Discussionmentioning

confidence: 99%

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

Teng

Wang

et al. 2019

ANZ Journal of Surgery

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Background Wedge resection via video‐assisted thoracoscopic surgery (VATS) is the best choice for the diagnosis of sub‐solid lung nodules. Preoperative localization is utilized to increase the success rate of this procedure. We aimed to evaluate the effectiveness of preoperative coil localization in VATS wedge resection for sub‐solid lung nodules. Methods From October 2015 to August 2018, 42 patients with 55 sub‐solid lung nodules underwent computed tomography‐guided coil localization with subsequent VATS wedge resection in our centre. Data regarding visible coil rates, technical success of the wedge resection and pathological results were collected and analysed retrospectively. Results A total of 55 sub‐solid lung nodules were localized in 42 patients. Thirty‐three patients had one nodule and nine patients had multiple nodules. Fifty‐two coils (52/55, 94.5%) were visible during the VATS. The mean duration of each coil localization was 14.3 ± 4.8 min (range 7–40 min). Three patients (7%) experienced pneumothorax after coil localization. VATS wedge resection was successfully performed for 53 nodules (53/55, 96.4%). The remaining two nodules were treated directly with lobectomy. The nine patients who had multiple nodules underwent one‐stage VATS wedge resection of all nodules. The mean duration of the VATS in the 42 patients was 159.3 ± 83.4 min (range 60–360 min) while the mean blood loss was 119.3 ± 115.3 mL (range 10–700 mL). Conclusion Preoperative computed tomography‐guided coil localization is a safe and effective method to facilitate high success rates for diagnostic VATS wedge resection for sub‐solid nodules.

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“…In decades, various techniques, including preoperative localization procedures, intraoperative localization using imaging modalities such as intraoperative ultrasonography, hook-wire, contrast media (5,6), dyes, microcoil, finger palpation, radio-guided, were used to overcome the aforementioned unfavorable factors, and the positive and negative aspects have been described (7). Along with the application of various localization methods and the accumulation of operating experience, numerous of doctors have been gradually recognized that physical methods such as hook wire localization showed excellent superiority (8)(9)(10)(11)(12)(13). In addition, this method is also relatively safe, since the operating procedure takes shorter time.…”

Section: Introductionmentioning

confidence: 99%

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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Simultaneous Multiple Preoperative Localizations of Small Pulmonary Lesions Using a Short Hook Wire and Suture System

Abstract: Simultaneous multiple hook wire placements before VATS were clinically feasible, but increased the complication rate and lengthened the procedure time.

Cited by 29 publications

References 16 publications

Modified hook‐wire placement technique for localizing multiple pulmonary nodules

Modified hook‐wire placement technique for localizing multiple pulmonary nodules

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

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

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