Computed Tomography Guided Hook-wire Precise Localization and Minimally Invasive Resection of Pulmonary Nodules
10.3779/j.issn.1009-3419.2015.11.04
- VernacularTitle:CT引导下Hook-w ire精确定位并微创切除肺结节
- Author:
WANG TONG
1
;
MA SHAOHUA
;
YAN TIANSHENG
;
SONG JINTAO
;
WANG KEYI
;
HE WEI
;
BAI JIE
Author Information
1. 北京大学第三医院胸外科
- Keywords:
Ground glass opacity;
Video-assisted thoracic surgery;
CT-guided Hook-wire localization
- From:
Chinese Journal of Lung Cancer
2015;(11):680-685
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Localization of pulmonary ground glass nodule is the technical diffculty of minimally invasive operation resection. hTe aim of this study is to evaluate the value of computed tomography (CT)-guided Hook-wire precise localization in resection of pulmonary nodules by video-assisted thoracoscopic surgery (VATS) as well as to discuss the necessity and feasibility of surgical resection of GGOs through a minimally invasive approach.Methods CT-guided Hook-wire precise localization and wedge resection was done on 25 cases with 26 pulmonary nodules by VATS from May 2013 to June 2015. hTe effcacy of localization was evaluated in terms of procedure time, VATS success rate, and associated complications of localization.Results All the 26 pulmonary nodules (6 solid nodules and 20 GGOs ) of 25 patients (10 males and 15 females) were preoperatively detected and localized with Hook-wire under CT guidance. Nodule diameters ranged from 5 mm-20 mm (mean: 8 mm). hTe distance of lung lesions from the nearest pleural surfaces ranged within 5 mm-30 mm (mean: 14 mm). All resections of lesions guided by the Hook-wire were successfully performed by VATS (success rate: 100%). hTe mean procedure time for the CT-guided Hook-wire localization was 10 min (range: 5 min-10 min). hTe mean procedure time for VATS wedge resection was 20 min (range: 15 min-40 min). hTe mean hospital time was 4 d (range: 3 d-6 d). hTe major complication of CT-guided Hook-wire localization was mild pneumothorax in 4 patients, but no one needed chest tube drain-age. Wedge resection was performed successfully in all cases. hTe dislocation of Hook-wire was found in only one patient dur-ing the operation, but the lesion was still successfully resected under VATS. Results of pathological examination of 16 mGGOs revealed 8 primary lung cancers and 8 nonspeciifc chronic inlfammations. Results of pathological examination of 4 pGGOs re-vealed 1 primary lung cancers, 1 atypical adenomatous hyperplasia (AAH), and 2 nonspeciifc chronic inlfammations.Conclu-sion hTe preoperative CT-guided Hook-wire localization for pulmonary nodules particularly for GGOs is an effective and safe technique to assist VATS resection of the nodules. It can increase the ratio of lung wedge resection with little complications and may be better used in clinical diagnosis and treatment of small pulmonary nodules with VATS. Lung mGGOs carry a high risk of malignancy. Aggressive surgical resection of these mGGOs is necessary and feasible.
