Application of CT-guided microcoil localization in single utility port video-assisted thoracoscopic surgery for small pulmonary nodules (diameter≤15 mm): A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YU Ao , JIAO Zichen , ZHOU Yong , CHEN Baojun ,  WANG Tao

Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, P.R.China;

Corresponding?author：

WANG Tao, Email: wangtao_pumc@live.cn

Keywords：

Microcoil; pulmonary nodule; localization; surgery

DOI：

10.7507/1007-4848.202009053

Video：

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Objective To explore the application value of CT-guided microcoil localization in pulmonary nodule (diameter≤15 mm) surgery.Methods The clinical data of 175 patients with pulmonary nodules who underwent single utility port video-assisted thoracoscopic surgery at Nanjing Drum Tower Hospital from August 2018 to December 2019 were retrospectively analyzed. According to whether CT-guided coil localization was performed before operation, they were divided into a locating group and a non-locating group. There were 84 patients (34 males, 50 females, aged 57.8±8.8 years) in the locating group and 91 patients (46 males, 45 females, aged 57.6±10.8 years) in the non-locating group. The localization success rate, localization time, incidence of complications, surgical and postoperative conditions were analyzed between the two groups.Results All 84 patients in the locating group were successfully located, and localization time was 19.0±3.6 minutes. Among them, 19 (22.6%) patients had a small pneumothorax, 4 (4.8%) pulmonary hemorrhage and 2 (2.4%) coil shift; 6 (7.1%) patients had mild pain, 3 (3.6%) moderate pain and 1 (1.2%) severe pain. Sex (P=0.181), age (P=0.673), nodule location (P=0.167), nature of lesion (P=0.244), rate of conversion to thoracotomy (P=0.414), rate of disposable resection of nodules (P=0.251) and postoperative hospital stay (P=0.207) were similar between the two groups. There were significant differences in nodule size (P<0.001), nature of nodule (P<0.001), the shortest distance from nodule to pleura (P<0.001), operation time (P<0.001), lung volume by wedge resection (P=0.031), number of staplers (P<0.001) and total hospitalization costs (P<0.001) between the two groups.Conclusion CT-guided microcoil localization has the characteristics of high success rate, and is simple, practicable, effective, safe and minimally invasive. Preoperative CT-guided microcoil localization has important clinical application value for small pulmonary nodules, especially those with small size, deep location and less solid components. It can effectively shorten the operation time, reduce surgical trauma and lower hospitalization costs, which is a preoperative localization technique worthy of popularization.

Citation： YU Ao, JIAO Zichen, ZHOU Yong, CHEN Baojun, WANG Tao. Application of CT-guided microcoil localization in single utility port video-assisted thoracoscopic surgery for small pulmonary nodules (diameter≤15 mm): A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(1): 68-73. doi: 10.7507/1007-4848.202009053 Copy

1.	陳萬青, 鄭榮壽, 張思維, 等. 2013年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
2.	Duann CW, Hung JJ, Hsu PK, et al. Surgical outcomes in lung cancer presenting as ground-glass opacities of 3 cm or less: A review of 5 years' experience. J Chin Med Assoc, 2013, 76(12): 693-697.
3.	沈誠, 李鵬飛, 李玨, 等. 胸腔鏡手術下肺小結節常見定位方法研究進展. 中國肺癌雜志, 2018, 21(8): 628-634.
4.	楊楠, 劉燦輝, 強勇. 胸腔鏡下孤立性肺結節術前定位進展. 中國胸心血管外科臨床雜志, 2015, 22(7): 696-699.
5.	Gruber-Rouh T, Naguib NNN, Beeres M, et al. CT-guided hook-wire localisation prior to video-assisted thoracoscopic surgery of pulmonary lesions. Clin Radiol, 2017, 72(10): 897-898.
6.	伍勇勇, 何雪明, 何忠良, 等. 術前CT引導Hook-wire定位下胸腔鏡肺小結節切除28例分析. 浙江醫學, 2017, 39(23): 2147-2149.
7.	黃小燕, 鄭屹峰, 潘鋒, 等. 單一肺結節與兩枚以上肺結節胸腔鏡切除術前CT引導下hook-wire定位的應用價值. 腫瘤學雜志, 2017, 23(10): 914-917.
8.	Qi H, Wan C, Zhang L, et al. Early effective treatment of small pulmonary nodules with video-assisted thoracoscopic surgery combined with CT-guided dual-barbed hookwire localization. Oncotarget, 2017, 8(24): 38793-38801.
9.	Chen YR, Yeow KM, Lee JY, et al. CT-guided hook wire localization of subpleural lung lesions for video-assisted thoracoscopic surgery (VATS). J Formos Med Assoc, 2007, 106(11): 911-918.
10.	Kleedehn M, Kim DH, Lee FT, et al. Preoperative pulmonary nodule localization: A comparison of methylene blue and hookwire techniques. AJR Am J Roentgenol, 2016, 207(6): 1334-1339.
11.	Lachkar S, Baste JM, Thiberville L, et al. Pleural dye marking using radial endobronchial ultrasound and virtual bronchoscopy before sublobar pulmonary resection for small peripheral nodules. Respiration, 2018, 95(5): 354-361.
12.	Zhou Z, Wang Z, Zheng Z, et al. An "alternative finger" in robotic-assisted thoracic surgery: Intraoperative ultrasound localization of pulmonary nodules. Med Ultrason, 2017, 19(4): 374-379.
13.	Keating JJ, Kennedy GT, Singhal S. Identification of a subcentimeter pulmonary adenocarcinoma using intraoperative near-infrared imaging during video-assisted thoracoscopic surgery. J Thorac Cardiovasc Surg, 2015, 149(3): e51-53.
14.	Wang C, Wang Z, Zhao T, et al. Optical molecular imaging for tumor detection and image-guided surgery. Biomaterials, 2018, 157: 62-75.
15.	Tay JH, Wallbridge PD, Larobina M, et al. Electromagnetic navigation bronchoscopy-directed pleural tattoo to aid surgical resection of peripheral pulmonary lesions. J Bronchology Interv Pulmonol, 2016, 23(3): 245-250.
16.	Folch EE, Bowling MR, Gildea TR, et al. Design of a prospective, multicenter, global, cohort study of electromagnetic navigation bronchoscopy. BMC Pulm Med, 2016, 16(1): 60.
17.	Donahoe LL, Nguyen ET, Chung TB, et al. CT-guided microcoil VATS resection of lung nodules: A single-centre experience and review of the literature. J Thorac Dis, 2016, 8(8): 1986-1994.
18.	Park CH, Han K, Hur J, et al. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: A systematic review and meta-analysis. Chest, 2017, 151(2): 316-328.
19.	何曉峰, 曹彬, 陳寶俊, 等. 術前CT下彈簧圈定位肺結節在胸腔鏡下肺結節切除術中應用的隨機對照試驗. 中國胸心血管外科臨床雜志, 2017, 24(11): 858-862.
20.	Finley RJ, Mayo JR, Grant K, et al. Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: A prospective randomized controlled trial. J Thorac Cardiovasc Surg, 2015, 149(1): 26-31.
21.	Chen X, Wang S, Hao Z, et al. Wire ‘missing’: A rare presentation of preoperative localization wire system dislocation. J Cardiothorac Surg, 2014, 9(1): 162.
22.	Mao R, Shi W, Chen D, et al. Technique of skeletal navigation for localizing solitary pulmonary nodules. J Surg Oncol, 2017, 116(6): 763-765.

1. 陳萬青, 鄭榮壽, 張思維, 等. 2013年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
2. Duann CW, Hung JJ, Hsu PK, et al. Surgical outcomes in lung cancer presenting as ground-glass opacities of 3 cm or less: A review of 5 years' experience. J Chin Med Assoc, 2013, 76(12): 693-697.
3. 沈誠, 李鵬飛, 李玨, 等. 胸腔鏡手術下肺小結節常見定位方法研究進展. 中國肺癌雜志, 2018, 21(8): 628-634.
4. 楊楠, 劉燦輝, 強勇. 胸腔鏡下孤立性肺結節術前定位進展. 中國胸心血管外科臨床雜志, 2015, 22(7): 696-699.
5. Gruber-Rouh T, Naguib NNN, Beeres M, et al. CT-guided hook-wire localisation prior to video-assisted thoracoscopic surgery of pulmonary lesions. Clin Radiol, 2017, 72(10): 897-898.
6. 伍勇勇, 何雪明, 何忠良, 等. 術前CT引導Hook-wire定位下胸腔鏡肺小結節切除28例分析. 浙江醫學, 2017, 39(23): 2147-2149.
7. 黃小燕, 鄭屹峰, 潘鋒, 等. 單一肺結節與兩枚以上肺結節胸腔鏡切除術前CT引導下hook-wire定位的應用價值. 腫瘤學雜志, 2017, 23(10): 914-917.
8. Qi H, Wan C, Zhang L, et al. Early effective treatment of small pulmonary nodules with video-assisted thoracoscopic surgery combined with CT-guided dual-barbed hookwire localization. Oncotarget, 2017, 8(24): 38793-38801.
9. Chen YR, Yeow KM, Lee JY, et al. CT-guided hook wire localization of subpleural lung lesions for video-assisted thoracoscopic surgery (VATS). J Formos Med Assoc, 2007, 106(11): 911-918.
10. Kleedehn M, Kim DH, Lee FT, et al. Preoperative pulmonary nodule localization: A comparison of methylene blue and hookwire techniques. AJR Am J Roentgenol, 2016, 207(6): 1334-1339.
11. Lachkar S, Baste JM, Thiberville L, et al. Pleural dye marking using radial endobronchial ultrasound and virtual bronchoscopy before sublobar pulmonary resection for small peripheral nodules. Respiration, 2018, 95(5): 354-361.
12. Zhou Z, Wang Z, Zheng Z, et al. An "alternative finger" in robotic-assisted thoracic surgery: Intraoperative ultrasound localization of pulmonary nodules. Med Ultrason, 2017, 19(4): 374-379.
13. Keating JJ, Kennedy GT, Singhal S. Identification of a subcentimeter pulmonary adenocarcinoma using intraoperative near-infrared imaging during video-assisted thoracoscopic surgery. J Thorac Cardiovasc Surg, 2015, 149(3): e51-53.
14. Wang C, Wang Z, Zhao T, et al. Optical molecular imaging for tumor detection and image-guided surgery. Biomaterials, 2018, 157: 62-75.
15. Tay JH, Wallbridge PD, Larobina M, et al. Electromagnetic navigation bronchoscopy-directed pleural tattoo to aid surgical resection of peripheral pulmonary lesions. J Bronchology Interv Pulmonol, 2016, 23(3): 245-250.
16. Folch EE, Bowling MR, Gildea TR, et al. Design of a prospective, multicenter, global, cohort study of electromagnetic navigation bronchoscopy. BMC Pulm Med, 2016, 16(1): 60.
17. Donahoe LL, Nguyen ET, Chung TB, et al. CT-guided microcoil VATS resection of lung nodules: A single-centre experience and review of the literature. J Thorac Dis, 2016, 8(8): 1986-1994.
18. Park CH, Han K, Hur J, et al. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: A systematic review and meta-analysis. Chest, 2017, 151(2): 316-328.
19. 何曉峰, 曹彬, 陳寶俊, 等. 術前CT下彈簧圈定位肺結節在胸腔鏡下肺結節切除術中應用的隨機對照試驗. 中國胸心血管外科臨床雜志, 2017, 24(11): 858-862.
20. Finley RJ, Mayo JR, Grant K, et al. Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: A prospective randomized controlled trial. J Thorac Cardiovasc Surg, 2015, 149(1): 26-31.
21. Chen X, Wang S, Hao Z, et al. Wire ‘missing’: A rare presentation of preoperative localization wire system dislocation. J Cardiothorac Surg, 2014, 9(1): 162.
22. Mao R, Shi W, Chen D, et al. Technique of skeletal navigation for localizing solitary pulmonary nodules. J Surg Oncol, 2017, 116(6): 763-765.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of CT-guided microcoil localization in single utility port video-assisted thoracoscopic surgery for small pulmonary nodules (diameter≤15 mm): A retrospective cohort study

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