Preoperative localization of small pulmonary lesions with a short hook wire and suture system: experience with 168 procedures.
OBJECTIVE
To evaluate use of a short hook wire and suture system for preoperative localization of pulmonary nodular lesions.


METHODS
Percutaneous localization of 168 lesions was performed with computed tomographic (CT) guidance in 150 patients. Patients were classified into three groups: a 3-year early-learning experience of treatment of 40 lesions mainly in one institution (group A1), a more recent 4-year experience of treatment of 88 lesions in the same institution (group A2), and the roughly synchronous recent 3-year experience of treatment of 40 lesions in a different hospital (group B).


RESULTS
The hook wire was successfully placed without dislodgment in 146 patients, accounting for 164 (97.6%) of 168 lesions. Group A2 showed a success rate of 100%. There was no difference in patients among the three groups in regard to size of lesions or their distance from the pleural surface. In patients in groups A2 and B, the proportion of nodules with ground-glass opacity and primary lung carcinoma at CT was significantly greater than that in patients in group A1. In 168 placements, nonsymptomatic pneumothorax cases were observed in 54 (32.1%), hemorrhages into the lung were observed in 25 (14.9%), and hemorrhage into the pleural space was observed in one (0.6%). No patient complained of notable pain during or after the procedure, and no serious complication was experienced. Unsuccessful placement was caused by too shallow a puncture with the introducer needle.


CONCLUSIONS
This system with a flexible suture for preoperative localization has a high success rate.
Dendo
Shuichi
S
Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan.
Kanazawa
Susumu
S
Ando
Akio
A
Hyodo
Tsuyoshi
T
Kouno
Yoshihiro
Y
Yasui
Kotaro
K
Mimura
Hidefumi
H
Akaki
Shiro
S
Kuroda
Masahiro
M
Shimizu
Nobuyoshi
N
Hiraki
Yoshio
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013537:Sutures; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*