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@#Objective To compare the effectiveness and safety of preoperative lung localization by microcoil and anchor with scaled suture. Methods A total of 286 patients underwent CT-guided puncture localization consecutively between October 2019 and December 2020 in our hospital. According to the different methods of localization, they were divided into a microcoil group (n=139, including 49 males and 90 females, aged 57.92±10.51 years) and an anchor group (n=147, including 53 males and 94 females, aged 56.68±11.31 years). The clinical data of the patients were compared. Results A total of 173 nodules were localized in the microcoil group, and 169 nodules in the anchor group. The localization success rate was similar in the two groups. However, the anchor group was significantly better than the microcoil group in the localization time (8.15±2.55 min vs. 9.53±3.08 min, P=0.001), the pathological receiving time (30.46±14.41 min vs. 34.96±19.75 min, P=0.029), and the hemoptysis rate (10.7% vs. 30.1%, P=0.001), but the pneumothorax rate was higher in the anchor group (21.3% vs. 11.0%, P=0.006). Conclusion Preoperative localization of small pulmonary nodules using anchor with suture is practical and safe. Due to its simplicity and convenience, it is worth of promotion in the clinic.
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Objective To study the application of regional localization method in the thoracoscopic resection of small pulmonary nodule.Methods Sixty-eight cases of small pulmonary nodules were located by applying the small pulmonary nodules regional localization method,and the clinical effect was intraoperatively observed.The ROC curve was used to find the best node for the nodule maximum diameter and minimum distance from the pleural.Results The once successful localization was obtained in 65 cases with the success rate of 95.6％.The best node of the maximum diameter of small pulmonary nodules was 1.0 cm,and the shortest distance from the pleura was 1.3 cm.Conclusion The regional localization method in the thoracoscopic resection of small pulmonary nodule has high accuracy.
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Objective To assess the clinical value of preoperative CT-guided microcoil positioning of small solitary pulmonary nodule (SPN) in assisting video-assisted thoracic surgery (VATS) procedure to more quickly and more precisely remove small pulmonary lesions.Methods The clinical data of 90 patients with SPN,who were admitted to authors' hospital during the period from June 2014 to May 2016 to receive VATS,were retrospective analyzed.Preoperative CT-guided microcoil positioning of SPN was employed in 45 patients (group A),while other 45 patients (group B) did not receive preoperative positioning of SPN.The pulmonary lobar wedge resection time,the transfer rate of changing to open chest operation,postoperative hospitalization time,the success rate of microcoil positioning of SPN,complications,etc.of both groups were statistically analyzed.The safety of preoperative CT-guided microcoil positioning of SPN was evaluated,and its benefit-enhancing value for VATS was discussed.Results In group A,the success rate of VATS was 100％ and the success rate of SPN positioning was 95.6％.Postoperative complications included pneumothorax (n=5),pulmonay surface hemorrhage (n=6),and dislodgement of microcoil (n=2).In group B,the success rate of VATS was 84.4％ and the transfer rate of changing to open chest operation was 15.6％.In group A,the manipulation time of VATS was (17.7±2.8) min,the postoperative hospitalization time was (6.2±1.7) days,and the transfer rate of changing to open chest operation was 0％,which were strikingly lower than those in group B;the differences between the two groups were statistically significant (P＜0.05).Conclusion Preoperative CT-guided microcoil positioning of small SPN can assist VATS procedure to remove small pulmonary lesions more quickly and more precisely,it can effectively reduce the transfer rate of changing to open chest operation,shorten the manipulation time of VATS as well as the postoperative hospitalization time.
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Objective To study CT-guided localization of additional pulmonary nodules with microcoils prior to video-assisted thoracoscopic surgery (VATS) resection in patients with suspected lung cancer.Methods Eleven patients suspected lung cancer underwent preoperative microcoils localization towards additional small pulmonary nodules.The head of microcoil was pinpointed adjacent to the target nodule while its end tail remained above the visceral pleura.VATS were performed within 24 hours, and comprehensive assessments were conducted according to surgical and pathological outcomes of primary and additional lesions, and suitable surgical processes were followed.Results All 11 localizing pulmonary nodules (4-15 mm in diameter) were successfully removed after VATS, 9 microcoils'' end tails of which were placed above visceral pleural surface.There were no serious complications related with localizing procedure.Other 16 lesions including 11 primary ones were resected.The surgical and pathological outcomes for lung lesions were utterly assessed.Conclusion Microcoil preoperative localization provides helpful orientation for complete resection and assessment of multiple pulmonary lesions in patients with suspected lung cancer.
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Objective To discuss the clinical application of CT-guided localization of small pulmonary nodules (SPNs) by using double-hook-wire before the performance of video-assisted thoracoscopic (VATS) resection.Methods Before the performance of VATS resection,CT-guided localization by using doublehook-wire was carried out in 54 patients with SPNs (67 small pulmonary nodules in total) and CT-guided localization by using single-hook-wire was employed in 63 patients with SPNs(81 small pulmonary nodules in total).The location success rate and complication rate of the double-hook-wire technique and the singlehook-wire technique were calculated.Results The location success rate of CT-guided localization for SPNs by using double-hook-wire performed before VATS resection in 54 patients was 100％.The incidences of pneumothorax and hemorrhage were 29.6％ (16/54) and 48.1％ (26/54) respectively.In 63 patients receiving single-hook-wire technique,the location success rate for SPNs was 98.4％ (62/63).The incidences of pneumothorax and hemorrhage were 28.5％ (18/63) and 25.4％ (16/63) respectively.Conclusion CT-guided localization for SPNs by using double-hook-wire before VATS resection can reduce the risk of failure in positioning the hook-wire,and this technique is an important supplement for other localization techniques.