Clinical Study of Intra-operative Computed Tomography Guided Localization with A Hook-wire System for Small Ground Glass Opacities in Minimally Invasive Resection
10.3779/j.issn.1009-3419.2014.12.04
- VernacularTitle:CT引导下Hook-w ire定位肺磨玻璃样微小结节微创切除的临床研究
- Author:
CHU XIANGYANG
1
;
HOU XIAOBIN
;
ZHANG LIANBIN
;
XUE ZHIQIANG
;
REN ZHIPENG
;
WEN JIAXIN
;
LIU YI
;
MA KEFENG
;
SUN YU’E
Author Information
1. 解放军总医院胸外科
- Keywords:
Ground glass opacity;
Computed tomography-guided localization with a hook-wire system;
Mini-mally invasive resection
- From:
Chinese Journal of Lung Cancer
2014;(12):845-849
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Localization of pulmonary ground glass small nodule is the technical dif-ficulty of minimally invasive operation resection. The aim of this study is to evaluate the value of intraoperative computed tomography (CT)-guided localization using a hook-wire system for small ground glass opacity (GGO) in minimally invasive resection, as well as to discuss the necessity and feasibility of surgical resection of small GGOs (<10 mm) through a minimally invasive approach.MethodshTe records of 32 patients with 41 small GGOs who underwent intraoperative CT-guided double-thorn hook wire localization prior to video-assisted thoracoscopic wedge resection from October 2009 to October 2013 were retrospectively reviewed. All patients received video-assisted thoracoscopic surgery (VATS) within 10 min atfer wire localiza-tion. hTe effcacy of intraoperative localization was evaluated in terms of procedure time, VATS success rate, and associated complications of localization.Results A total of 32 patients (15 males and 17 females) underwent 41 VATS resections, with 2 simultaneous nodule resections performed in 3 patients, 3 lesion resections in 1 patient, and 5 lesions in a patient. Nodule di-ameters ranged from 2 mm-10 mm (mean: 5 mm). hTe distance of lung lesions from the nearest pleural surfaces ranged within 5 mm-24 mm (mean: 12.5 mm). All resections of lesions guided by the inserted hook wires were successfully performed by VATS (100% success rate). hTe mean procedure time for the CT-guided hook wire localization was 8.4 min (range: 4 min-18 min). hTe mean procedure time for VATS was 32 min (range: 14 min-98 min). hTe median hospital time was 8 d (range: 5 d-14 d). Results of pathological examination revealed 28 primary lung cancers, 9 atypical adenomatous hyperplasia, and 4 nonspe-ciifc chronic inlfammations. No major complication related to the intraoperative hook wire localization and VATS was noted. Conclusion Intraoperative CT-guided hook wire localization is useful, particularly in small GGO localization in VATS wedge resection and has a signiifcantly low rate of minor complications. Lung GGOs carry a 90% risk of malignancy. Aggressive surgi-cal resection of these GGOs is necessary and feasible through the guidance of intraoperative CT localization technique.
