Pre-operative localization of solitary pulmonary nodules with computed tomography-guided hook wire: report of 181 patients.

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Serval ID
serval:BIB_DBDAA0710238
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pre-operative localization of solitary pulmonary nodules with computed tomography-guided hook wire: report of 181 patients.
Journal
Journal of Cardiothoracic Surgery
Author(s)
Hanauer M., Perentes J.Y., Krueger T., Ris H.B., Bize P., Schmidt S., Gonzalez M.
ISSN
1749-8090 (Electronic)
ISSN-L
1749-8090
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
11
Number
1
Pages
5
Language
english
Notes
Publication types: Journal Article Publication Status: epublish
Abstract
BACKGROUND: Video-assisted thoracic surgery (VATS) is currently performed to diagnose and treat solitary pulmonary nodules (SPN). However, the intra-operative identification of deep nodules can be challenging with VATS as the lung is difficult to palpate. The aim of the study was to report the utility and the results of pre-operative computed tomography (CT)-guided hook wire localization of SPN.
METHODS: All records of the patients undergoing CT-guided hook wire localization prior to VATS resection for SPN between 2002 and 2013 were reviewed. The efficacy in localizing the nodule, hook wire complications, necessity to convert VATS to thoracotomy and the histology of SPN are reported.
RESULTS: One hundred eighty-one patients (90 females, mean age 63 y, range 28-82 y) underwent 187 pulmonary resections after CT-guided hook wire localization. The mean SPN diameter was 10.3 mm (range: 4-29 mm). The mean distance of the lesion from the pleural surface was 11.6 mm (range: 0-45 mm). The mean time interval from hook wire insertion to VATS resection was 224 min (range 54-622 min). Hook wire complications included pneumothorax requiring chest tube drainage in 4 patients (2.1%) and mild parenchymal haemorrhage in 11 (5.9%) patients. Migration of the hook wire occurred in 7 patients (3.7%) although it did not affect the success of VATS resection (nodule location guided by the lung puncture site). Three patients underwent additional wedge resection by VATS during the same procedure because no lesion was identified in the surgical specimen. Conversion thoracotomy was required in 13 patients (7 %) for centrally localized lesions (6 patients) and pleural adhesions (7 patients). The mean operative time was 60 min (range 18-135 min). Pathological examination revealed a malignant lesion in 107 patients (59 %). The diagnostic yield was 98.3 %.
CONCLUSION: VATS resection for SPN after CT-guided hook wire localization for SPN is safe and allows for proper diagnosis with a low thoracotomy conversion rate.
Keywords
Adult, Aged, Aged, 80 and over, Female, Fiducial Markers, Follow-Up Studies, Humans, Lung Neoplasms/radiography, Lung Neoplasms/surgery, Male, Middle Aged, Preoperative Care/instrumentation, Preoperative Care/methods, Radiography, Interventional/instrumentation, Radiography, Interventional/methods, Retrospective Studies, Solitary Pulmonary Nodule/radiography, Solitary Pulmonary Nodule/surgery, Thoracic Surgery, Video-Assisted, Tomography, X-Ray Computed/instrumentation, Tomography, X-Ray Computed/methods, Treatment Outcome
Web of science
Open Access
Yes
Create date
07/02/2016 18:38
Last modification date
20/08/2019 17:00
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