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Li Z, Zhou Z, Feng K, Song X, Xu C, Li C, Zhao J, Ye L, Shen Z, Ding C. Comparison of laser guidance and freehand hook-wire for CT-guided preoperative localization of pulmonary nodules. J Cardiothorac Surg 2024; 19:182. [PMID: 38581004 PMCID: PMC10996078 DOI: 10.1186/s13019-024-02706-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/29/2024] [Indexed: 04/07/2024] Open
Abstract
PURPOSE In VATS surgery, precise preoperative localization is particularly crucial when dealing with small-diameter pulmonary nodules located deep within the lung parenchyma. The purpose of this study was to compare the efficacy and safety of laser guidance and freehand hook-wire for CT-guided preoperative localization of pulmonary nodules. METHODS This retrospective study was conducted on 164 patients who received either laser guidance or freehand hook-wire localization prior to Uni-port VATS from September 1st, 2022 to September 30th, 2023 at The First Affiliated Hospital of Soochow University. Patients were divided into laser guidance group and freehand group based on which technology was used. Preoperative localization data from all patients were compiled. The localization success and complication rates associated with the two groups were compared. The risk factors for common complications were analyzed. RESULTS The average time of the localization duration in the laser guidance group was shorter than the freehand group (p<0.001), and the average CT scan times in the laser guidance group was less than that in the freehand group (p<0.001). The hook-wire was closer to the nodule in the laser guidance group (p<0.001). After the localization of pulmonary nodules, a CT scan showed 14 cases of minor pneumothorax (22.58%) in the laser guidance group and 21 cases (20.59%) in the freehand group, indicating no statistical difference between the two groups (p=0.763). CT scans in the laser guidance group showed pulmonary minor hemorrhage in 8 cases (12.90%) and 6 cases (5.88%) in the freehand group, indicating no statistically significant difference between the two groups (p=0.119). Three patients (4.84%) in the laser guidance group and six patients (5.88%) in the freehand group had hook-wire dislodgement, showing no statistical difference between the two groups (p=0.776). CONCLUSION The laser guidance localization method possessed a greater precision and less localization duration and CT scan times compared to the freehand method. However, laser guidance group and freehand group do not differ in the appearance of complications such as pulmonary hemorrhage, pneumothorax and hook-wire dislodgement.
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Affiliation(s)
- Zijian Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ziyue Zhou
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Kunpeng Feng
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xinyu Song
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun Xu
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chang Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Li Ye
- Department of Marketing, Neorad Medical Technology (Shanghai) Co., Ltd., Shanghai, 201100, China
| | - Ziqing Shen
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China.
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Cheng Ding
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China.
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Han R, Wang LF, Teng F, Lin J, Xian YT, Lu Y, Wu AL. Presurgical computed tomography-guided localization of lung ground glass nodules: comparing hook-wire and indocyanine green. World J Surg Oncol 2024; 22:51. [PMID: 38336734 PMCID: PMC10858508 DOI: 10.1186/s12957-024-03331-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Presurgical computed tomography (CT)-guided localization is frequently employed to reduce the thoracotomy conversion rate, while increasing the rate of successful sublobar resection of ground glass nodules (GGNs) via video-assisted thoracoscopic surgery (VATS). In this study, we compared the clinical efficacies of presurgical CT-guided hook-wire and indocyanine green (IG)-based localization of GGNs. METHODS Between January 2018 and December 2021, we recruited 86 patients who underwent CT-guided hook-wire or IG-based GGN localization before VATS resection in our hospital, and compared the clinical efficiency and safety of both techniques. RESULTS A total of 38 patients with 39 GGNs were included in the hook-wire group, whereas 48 patients with 50 GGNs were included in the IG group. There were no significant disparities in the baseline data between the two groups of patients. According to our investigation, the technical success rates of CT-based hook-wire- and IG-based localization procedures were 97.4% and 100%, respectively (P = 1.000). Moreover, the significantly longer localization duration (15.3 ± 6.3 min vs. 11.2 ± 5.3 min, P = 0.002) and higher visual analog scale (4.5 ± 0.6 vs. 3.0 ± 0.5, P = 0.001) were observed in the hook-wire patients, than in the IG patients. Occurrence of pneumothorax was significantly higher in hook-wire patients (27.3% vs. 6.3%, P = 0.048). Lung hemorrhage seemed higher in hook-wire patients (28.9% vs. 12.5%, P = 0.057) but did not reach statistical significance. Lastly, the technical success rates of VATS sublobar resection were 97.4% and 100% in hook-wire and IG patients, respectively (P = 1.000). CONCLUSIONS Both hook-wire- and IG-based localization methods can effectively identified GGNs before VATS resection. Furthermore, IG-based localization resulted in fewer complications, lower pain scores, and a shorter duration of localization.
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Affiliation(s)
- Rui Han
- Department of Interventional Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Long-Fei Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Fei Teng
- Department of Interventional Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Jia Lin
- Department of Interventional Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Yu-Tao Xian
- Department of Interventional Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Yun Lu
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
| | - An-Le Wu
- Department of Interventional Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China.
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Yang Y, Qin C, Ma Y, Lu Z, Zhang Y, Li T. Application of computed tomography-guided hook-wire localization technique in thoracoscopic surgery for small pulmonary nodules (≤ 10 mm). J Cardiothorac Surg 2023; 18:99. [PMID: 37020219 PMCID: PMC10074372 DOI: 10.1186/s13019-023-02188-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/12/2023] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the safety and efficacy of the computed tomography (CT)-guided hook-wire localization technique in thoracoscopic surgery for small pulmonary nodules (≤ 10 mm) and to identify the risk factors for localization-related complications. METHODS The medical records of 150 patients with small pulmonary nodules treated from January 2018 to June 2021 were retrospectively analyzed. According to preoperative hook-wire positioning status, they were divided into the localization group (50 cases) or the control group (100 cases). The operation time, intraoperative blood loss, hospital stay, and conversion rate to thoracotomy were recorded and compared between groups. Uni- and multivariate binary logistic regression analysis was used to identify the risk factors for localization-related complications. RESULTS A total of 58 nodules were localized in 50 patients in the localization group, and the localization success rate was 98.3% (57/58). In one case, the positioning pin fell off before wedge resection was performed. The mean nodule diameter was 7.05 mm (range, 2.8-10.0 mm), while the mean depth from the pleura was 22.40 mm (range, 5.47-79.47 mm). There were 8 cases (16%) of asymptomatic pneumothorax, 2 (4%) of intrapulmonary hemorrhage, and 1 (2%) of pleural reaction.The mean operation time of the localization group (103.88 ± 41.74 min) was significantly shorter than that of the control group (133.30 ± 45.42 min) (P < 0.05). The mean intraoperative blood loss of the localization group (44.20 ± 34.17 mL) was significantly lower than that of the control group (112.30 ± 219.90 mL) (P < 0.05). The mean hospital stay of the localization group (7.96 ± 2.34 days) was significantly shorter than that of the control group (9.21 ± 3.25 days).Multivariate binary logistic analysis showed that localization times of small pulmonary nodules in the localization group was an independent risk factor for localization-related pneumothorax. CONCLUSIONS Our results suggest that the CT-guided hook-wire localization technique is beneficial for localizing small pulmonary nodules. Specifically, it is helpful for the diagnosis and treatment of early lung cancer because it can accurately remove lesions, decrease intraoperative blood loss, shorten operation time and hospitalization stay, and reduce thoracotomy conversion rate. Simultaneous positioning of multiple nodules can easily lead to positioning-related pneumothorax.
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Affiliation(s)
- Yuan Yang
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Chenhui Qin
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yue Ma
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Zhongting Lu
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yun Zhang
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Tao Li
- Department of Surgical Oncology, Tumor Hospital, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
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Zhang H, Li Y, Yimin N, He Z, Chen X. CT-guided hook-wire localization of malignant pulmonary nodules for video assisted thoracoscopic surgery. J Cardiothorac Surg 2020; 15:307. [PMID: 33036640 PMCID: PMC7545541 DOI: 10.1186/s13019-020-01279-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/01/2020] [Indexed: 12/26/2022] Open
Abstract
Objectives Video assisted thoracoscopic surgery (VATS) can currently be used to diagnose and treat pulmonary nodules. However, intraoperative location of pulmonary nodules in VATS is challenging due to their small diameter and deep location in the pulmonary parenchyma. The purpose of this study was to report the clinical safety and effectiveness of CT-guided hook-wire for preoperative localization of malignant pulmonary nodules smaller than 1 cm in diameter. Methods From February 2017 to January 2018, we collected the data of 80 patients with malignant pulmonary nodules less than 1 cm in diameter who underwent CT-guided hook-wire preoperative localization and VATS surgery. The effectiveness of preoperative localization was evaluated based on surgical duration, success rate of VATS surgery, and localization-related complications. Results The diameter of pulmonary nodules were 0.85 ± 0.17 mm with a distance to the pleural surface of 19.66 ± 14.10 mm. The length of the hook-wire in the lung parenchyma was 29.17 ± 13.14 mm and hook-wire dislodgement occurred in 2 patients. Complications included 27 cases of minor pneumothorax and 18 cases of mild parenchymal hemorrhage. A significant correlation was observed between the length of the hook-wire in the lung parenchyma and mild parenchymal hemorrhage (P = 0.044). The average time of hook-wire localization was 9.0 ± 2.6 min and the average operation time for VATS was 89.02 ± 23.35 min without conversion thoracotomy. Conclusions CT-guided hook-wire localization of the lesion during VATS resection is safe for malignant pulmonary nodules with diameter less than 1 cm.
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Affiliation(s)
- Huijun Zhang
- Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, Shanghai, 200040, China.
| | - Ying Li
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Nadier Yimin
- Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, Shanghai, 200040, China
| | - Zelai He
- Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China.
| | - Xiaofeng Chen
- Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, Shanghai, 200040, China.
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Zhang H, Si T, Guo Z. Clinicopathologic characteristics of pulmonary ground glass opacity located preoperatively using a Hook-wire guidewire. J Interv Med 2020; 3:89-92. [PMID: 34805914 PMCID: PMC8562163 DOI: 10.1016/j.jimed.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate the relationship between the clinical and imaging features of ground glass opacity (GGO) localized using a preoperative Hook-wire guidewire and postoperative pathology. Method Preoperative Hook-wire guidewire localization was performed in 83 patients with GGO less than 2 cm, and their clinical data, imaging data, and postoperative pathology findings were retrospectively analyzed. The images were classified as pure GGO (pGGO) or mixed GGO (mGGO). The relationship between clinical and imaging features and postoperative pathology was analyzed. Result The 83 cases were colocalized, and the success rate of the guidewire positioning was 100%. Complications included pneumothorax (19.2% [16/83]) and the incidence of minor bleeding (30.2 [25/83]). Forty-seven patients had mGGO and 36 had pGGO. Among the 47 cases of mGGO, 18 (38.3%) were invasive adenocarcinoma (IAC), 18 (38.3%) were microinvasive adenocarcinoma (MIA), 8 (17.0%) were adenocarcinoma in situ (AIS), 2 (4.3%) were atypical adenomatous hyperplasia (AAH), and 1 (2.1%) was benign. Among the 36 cases of pGGO, 6 (16.7%) were IAC, 13 (36.1%) were MIA, 8 (22.2%) were AIS, 2 (5.6%) were AAH, and 7 (19.4%) cases were benign lesions. A significantly higher proportion of patients with IAC had mGGO than pGGO (21.7% vs. 7.2%, respectively; p = 0.004). Among patients with mGGO, a higher proportion of them had a nodule diameter of ≥1 cm than those with a diameter of <1 cm (25.5% vs. 12.8%, respectively; p = 0.003). There was no significant difference in age, location distribution, or pathological type. Conclusion Preoperative CT-guided Hook-wire guidewire positioning was safe with minor complications. A significantly higher proportion of patients with IAC had mGGO than pGGO. Patients with mGGO and a nodule diameter ≥1 cm require active treatment.
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Affiliation(s)
- Haonan Zhang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, 300060, China
| | - Tongguo Si
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, 300060, China
| | - Zhi Guo
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, 300060, China
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