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.	陈万青, 郑荣寿, 张思维, 等. 2013年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 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.	沈诚, 李鹏飞, 李珏, 等. 胸腔镜手术下肺小结节常见定位方法研究进展. 中国肺癌杂志, 2018, 21(8): 628-634.
4.	杨楠, 刘灿辉, 强勇. 胸腔镜下孤立性肺结节术前定位进展. 中国胸心血管外科临床杂志, 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. 术前CT引导Hook-wire定位下胸腔镜肺小结节切除28例分析. 浙江医学, 2017, 39(23): 2147-2149.
7.	黄小燕, 郑屹峰, 潘锋, 等. 单一肺结节与两枚以上肺结节胸腔镜切除术前CT引导下hook-wire定位的应用价值. 肿瘤学杂志, 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.	何晓峰, 曹彬, 陈宝俊, 等. 术前CT下弹簧圈定位肺结节在胸腔镜下肺结节切除术中应用的随机对照试验. 中国胸心血管外科临床杂志, 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. 陈万青, 郑荣寿, 张思维, 等. 2013年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 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. 沈诚, 李鹏飞, 李珏, 等. 胸腔镜手术下肺小结节常见定位方法研究进展. 中国肺癌杂志, 2018, 21(8): 628-634.
4. 杨楠, 刘灿辉, 强勇. 胸腔镜下孤立性肺结节术前定位进展. 中国胸心血管外科临床杂志, 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. 术前CT引导Hook-wire定位下胸腔镜肺小结节切除28例分析. 浙江医学, 2017, 39(23): 2147-2149.
7. 黄小燕, 郑屹峰, 潘锋, 等. 单一肺结节与两枚以上肺结节胸腔镜切除术前CT引导下hook-wire定位的应用价值. 肿瘤学杂志, 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. 何晓峰, 曹彬, 陈宝俊, 等. 术前CT下弹簧圈定位肺结节在胸腔镜下肺结节切除术中应用的随机对照试验. 中国胸心血管外科临床杂志, 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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