[CT-guided hookwire localization of small solitary pulmonary nodules in video-assisted thoracoscopic surgery].
OBJECTIVE
Video-assisted thoracoscopic surgery (VATS) provides a minimally invasive approach to resect small solitary pulmonary nodules (SSPN). The aim of this study is to evaluate the efficacy and safety of preoperative CT-guided hookwire localization for SSPN in VATS.


METHODS
Hookwire was used to localize 26 SSPN under CT guidance in 24 patients (14 male, 10 female, age range 21-61 years, mean 52.3 years), preoperatively, and wedge resection was performed through VATS. The lesion size, distance from the lesion to parietal pleura, the time of localization and complications were evaluated.


RESULTS
All the 26 pulmonary nodules were preoperatively detected and localized with hookwire under CT-guidance. The mean lesion size was 10.05 +/- 3.08 mm in diameter, and the mean distance from lesion to parietal pleura was 10.09 +/- 2.62 mm. The mean localization time was 20.18 +/- 7.16 min, and then the nodules were removed by VATS within 18 +/- 6.65 min. The major complication of CT-guided hookwire localization was mild pneumothorax in 6 patients (25.0%), but no one needed chest tube drainage. The dislodgment of hookwire was found in only one patient (4.2%) during the operation, but the lesion was still successfully resected under VATS. Of those patients, 8 were confirmed to have a primary NSCLC by rapid pathologic diagnosis during VATS wedge resection, and then VATS lobectomies were performed.


CONCLUSIONS
The preoperative CT-guided hookwire localization for small solitary pulmonary nodules is an effective and safe technique to assist VATS resection of the nodules.
Zhou
Jian-Hua
JH
Department of Thoracic Surgery, Cancer Hospital, Fudan University, Shanghai 200032, China.
Li
Wen-Tao
WT
Chen
Hai-Quan
HQ
Peng
Wei-Jun
WJ
Xiang
Jia-Qing
JQ
Zhang
Ya-Wei
YW
Wang
Sheng-Ping
SP
Yang
Fu
F
Zhou
Xian
X
Luo
Xiao-Yang
XY
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011030:Pneumothorax / Q000209:etiology; D057234:Preoperative Period; D015641:Radiography, Interventional; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D055815:Young Adult