Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study.
BACKGROUND
Small peripheral lung nodules detected on computed tomography (CT) scans are often difficult to find during thoracoscopic resection, and the present localizing techniques are inefficient or impractical.


OBJECTIVE
To evaluate a novel marking procedure for small peripheral pulmonary nodules using an embolization coil.


METHODS
Patients with small peripheral pulmonary nodules underwent preoperative CT-guided nodule localization using an embolization coil and then resection by fluoroscopically-guided video-assisted thoracoscopic surgery (VATS; group A, n = 22), or, underwent conventional VATS without prior location procedures (group B, n = 16). Comparisons were made between group A and group B concerning operative time, hospitalization, postoperative drainage, and complications. Histopathological diagnoses were made immediately after resection of pulmonary nodules.


RESULTS
All CT-guided embolization coil fixations were successful. No patient in group A and eight (50%) in group B required conversion to open thoracotomy (P < 0.0001). No severe complications occurred in either group. Compared with group B, group A had a significantly shorter mean operative time and hospitalization, and less postoperative drainage.


CONCLUSIONS
Preoperative localization of small peripheral pulmonary nodules using CT-guided embolization coil insertion and subsequent fluoroscopically-guided VATS resection is safer and more effective than conventional VATS.
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China Xuzhou Medical College, Xuzhou, Jiangsu Province, PR China.
Li
L
Liu
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China.
Long Jiang
LJ
Zhang
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China.
Bo
B
Chen
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China.
Jian Min
JM
Cao
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China.
Guang Ming
GM
Lu
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China Xuzhou Medical College, Xuzhou, Jiangsu Province, PR China.
Lei
L
Yuan
Department of Pharmacology, Suzhou University, Suzhou, PR China.
Kai
K
Li
Department of Medical Imaging, Jingling Hospital, Clinical School of Medical College, Nanjing University, Xuanwu District, Nanjing, Jiangsu Province, PR China 13851656307@163.com.
Jian
J
Xu
D005260:Female; D057918:Fiducial Markers; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000601:surgery; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
Peripheral pulmonary nodule; diagnosis; embolization coil; hybrid operating room; video-assisted thoracoscopic surgery (VATS)