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
- VernacularTitle:CT 引导下弹簧圈定位在肺小结节（直径≤15 mm）单操作孔胸腔镜手术中应用的回顾性队列研究
- Author:
Ao YU
1
;
Zichen JIAO
1
;
Yong ZHOU
1
;
Baojun CHEN
1
;
Tao WANG
1
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, P.R.China
- Publication Type:Journal Article
- Keywords:
Microcoil;
pulmonary nodule;
localization;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(01):68-73
- CountryChina
- Language:Chinese
-
Abstract:
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.
