Reevaluation of the efficacy of preoperative computed tomography-guided hook wire localization: A retrospective analysis.
Int J Surg
; 51: 24-30, 2018 Mar.
Article
in En
| MEDLINE
| ID: mdl-29367030
ABSTRACT
BACKGROUND:
Small pulmonary nodules (SPNs) often cannot be accurately located during video-assisted thoracoscopic (VATS) resection, and preoperative computed tomography (CT)-guided localization performed using hook wire placement can be helpful. However, recent studies revealed a trend towards more frequent and severe complications occurring in association with hook wire insertion. The aim of this study is to reevaluate the safety, and reliability of the preoperative CT-guided hook wire localization technique and also identify the risk factors for localization-related pneumothorax.METHODS:
This retrospective study enrolled 95 patients (with 105 pulmonary nodules) who underwent preoperative CT-guided hook wire localization and followed VATS resection from January 2013 to September 2016. Univariate and multivariate logistic regression analyses were used to identify factors associated with localization-related pneumothorax.RESULTS:
All the 105 nodules were successfully localized. Two (1.9%) hook wires dislodged before VATS resection. Mean largest diameter of the nodules was 10.1â¯mm (range, 3-19â¯mm). Mean depth from the nearest pleural surface was 11.2â¯mm (range, 2-38â¯mm). Mean needle insertion depth was 24.3â¯mm (range, 4-49â¯mm), and mean procedure time was 17.3â¯min (range, 7-48â¯min). Asymptomatic pneumothorax was observed in 18 patients (18.9%) and hemorrhage in 7 patients (7.4%). Multivariate logistic regression analysis revealed the number of needle insertions (OR 8.893, pâ¯=â¯0.019) as the only significant independent risk factor of pneumothorax.CONCLUSIONS:
CT-guided hook wire localization is a safe, reliable and convenient technique and can be applied widely to facilitate the resection of SPNs. Simultaneous localization for multiple nodules in ipsilateral lung may be associated with a higher risk of localization-related pneumothorax.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgical Instruments
/
Preoperative Care
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Tomography, X-Ray Computed
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Multiple Pulmonary Nodules
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Lung Neoplasms
Type of study:
Etiology_studies
/
Evaluation_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Int J Surg
Year:
2018
Document type:
Article
Affiliation country:
China
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA