eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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3/2021
vol. 18
 
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abstract:
Original paper

Preoperative computed tomography-guided coil localization of sub-centimeter lung nodules

Yong-Guang Gao
1
,
Tao Wang
1
,
Yi-Bing Shi
1
,
Lei Zhu
1

1.
Department of Radiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
Kardiochirurgia i Torakochirurgia Polska 2021; 18 (3): 127-130
Online publish date: 2021/10/05
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Introduction
Lung nodules (LNs) are often identified in at-risk patients via low-dose computed tomography (CT) approaches. Sub-centimeter (≤ 1 cm) LNs (SCLNs) are particularly difficult for surgeons and pathologists to accurately treat and diagnose.
Aim: To evaluate the clinical efficacy of preoperative CT-guided coil localization for SCLNs.

Material and methods
Between January 2015 and December 2019, consecutive patients at our hospital with SCLNs underwent CT-guided coil localization followed by video-assisted thoracoscopic surgery (VATS). We then assessed rates of technical success corresponding to the localization and VATS-guided wedge resection procedures and measured rates of localization-related complications.

Results
In total, 52 patients were analyzed in this study, with 66 total SCLNs being localized with one coil each. CT-guided coil localization achieved a 93.9% (62/66) technical success rate, and a mean duration of 15.2 ±4.5 minutes. Following coil localization, 6 (11.5%) patients experienced pneumothorax and 4 (7.7%) patients suffered hemoptysis, with 1 patient requiring the insertion of a chest tube to alleviate pneumothorax. VATS-guided wedge resection was associated with a 100% technical success rate, and no patients needed to undergo conversion to thoracotomy. One-stage VATS-guided wedge resection was conducted in the 12 patients with multiple SCLNs. The mean VATS duration was 128.9 ±66.7 minutes, and mean blood loss associated with this procedure was 83.0 ±67.7 ml.

Conclusions
Preoperative CT-guided coil localization can safely and effectively achieve high rates of success when conducting the diagnostic VATS wedge resection of SCLNs.

keywords:

coil, lung nodule, sub-centimeter, localization

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