CT-guided localization with a Hook-wire system for nodular pulmonary lesions before video-assisted thoracoscopic resection / 中华放射学杂志

ABSTRACT

Objective To evaluate the feasibility,safety and clinical value of CT-guided localization with a Hook-wire system for nodular pulmonary lesions before video-assisted thoracoscopic resection (VATS). Methods The records of all patients undergoing VATS resection for solitary pulmonary nodules preoperatively localized by CT-guided a Hook-wire system were assessed with respect to failure to localize the lesion by the Hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of nodular pulmonary lesions. Results Sixty-eight patients with seventy four nodules underwent VATS resections. Preoperative CT-guided Hook-wire localization succeeded in all patients ( 100. 0% ). Conversion thoracotomy was necessary in 2 patients. The average operative time was ( 15 ±6)min. Asymptomatic complication rate was 70.6% (48/68), asymptomatic pneumothorax rate, asymptomatic hemorrhage rate and simultaneous pneumothorax and bleeding rate were 45.6% (31/68),25.0% ( 17/68 ) and 4. 4% ( 3/68 ), respectively. The mean hospitalization was ( 15 ± 6 ) days.Histological assessment revealed primary lung cancer (NSCLC) in 30, metastasis in 18, and nonmalignant disease in 26 nodules. Conclusions Video-assisted thoracoscopic resection of nodular pulmonary lesions previously localized by a CT-guided Hook-wire system is related to a low conversion thoracotomy rate, short operation time, and high safety. It for differential diagnosis and treatment.