31. COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS HOOK WIRE LOCALIZATION OF PULMONARY NODULE PRIOR TO VIDEO-ASSISTED THORACOSCOPIC SURGERY AT NATIONAL LUNG HOSPITAL IN 2023
Main Article Content
Abstract
Objective: Assess the efficiency and safety of computed tomography (CT)-guided hook-wire localization prior to video-assisted thoracoscopic surgery (VATS) at the National Lung Hospital in 2023.
Method: 19 patients were examined and treated at the National Lung Hospital from August 2023 to March 2024, with the diagnosis results of lung nodules on computed tomography scans and were localized of pulmonary nodules before VATS. Method: Case-series study.
Results: 94.74% of patients were successfully located lung nodules before surgery. The average age was 51.74 ± 10.96. The male-to-female ratio was approximately 1:2. The mean diameter of lung nodules was 13.32 ± 5.34 mm. Nodules were predominantly ground-glass nodules (GGNs) and part-solid GGNs, accounting for 78.9%. The mean distance from the nodules to the pleural surface was 10.95 ± 8.28 mm. The mean procedure time of localization was 5.74 ± 2.8 minutes. Common complications included parenchymal hemorrhage (47.4%), pneumothorax (10.5%), and hemothorax (10.5%), with no severe complications observed. Hook-wire dislodgement occurred in one patient (5.3%). All patients underwent completed resection of lung nodules and received frozen section intraoperatively. There were no cases requiring thoracotomy.
Conclusions: Preoperative percutaneous hook-wire localization is an effective and safe technique that facilitates video-assisted thoracoscopic surgery by accurately localizing small and deep pulmonary nodules.
Article Details
Keywords
Pulmonary nodules, hook-wire, localization, video-assisted thoracoscopic surgery.
References
British Thoracic Society guidelines for the investigation
and management of pulmonary nodules. Thorax. 2015;
70 Suppl 2:ii1-ii54.
[2] Vollmer I, Páez-Carpio A, Sánchez-Lorente D
et al., Preoperative localization of lung nodules:
A comparative analysis of hookwire and radio-guided
procedures. 2022. 2022;14(11):4329-40.
[3] Li W, Wang Y, He X et al., Combination of
CT-guided hookwire localization and video-assisted
thoracoscopic surgery for pulmonary
nodular lesions: Analysis of 103 patients. Oncol
Lett. 2012;4(4):824-8.
[4] Zhang H, Li Y, Yimin N et al., CT-guided hookwire
localization of malignant pulmonary nodules for
video assisted thoracoscopic surgery. J Cardiothorac
Surg. 2020;15(1):307.
[5] Li C, Liu B, Jia H et al., Computed tomography-
guided hook wire localization facilitates
video-assisted thoracoscopic surgery of pulmonary
ground-glass nodules. Thorac Cancer.2018;
9(9):1145-50.
[6] Wahidi MM, Govert JA, Goudar RK et al., Evidence
for the treatment of patients with pulmonary nodules:
When is it lung cancer?: ACCP evidence-based clinical
practice guidelines (2nd edition). Chest. 2007;132
(3 Suppl):94s-107s.
[7] Park JB, Lee SA, Lee WS et al., Computed tomography-
guided percutaneous hook wire localization of pulmonary
nodular lesions before video-assisted thoracoscopic
surgery: Highlighting technical aspects. Ann Thorac Med.
2019;14(3):205-12.
[8] Huang W, Ye H, Wu Y et al., Hook wire localization of
pulmonary pure ground-glass opacities for video-
assisted thoracoscopic surgery. The Thoracic and
cardiovascular surgeon. 2014;62(2):174-8.
[9] Suzuki K, Nagai K, Yoshida J et al., Video-assisted
thoracoscopic surgery for small indeterminate
pulmonary nodules: Indications for preoperative
marking. Chest. 1999;115(2):563-8.
[10] Yang Y, Qin C, Ma Y et al., Application of computed
tomography-guided hook-wire localization technique
in thoracoscopic surgery for small pulmonary nodules
(≤10 mm). Journal of Cardiothoracic Surgery. 2023;18(1):99.