Comparison of CT-guided localization using hook wire or coil before thoracoscopic surgery for ground glass nodules

Abstract

Objective: To compare two kinds of metal markers for preoperative localization of ground glass nodules (GGNs). Methods: We retrospectively investigated data from 198 cases of GGN localization and compared the success rate and complications of both approaches. Results: In the hook wire and coil groups, the success rates of CT-guided localization for GGNs were 99.2 and 98.7%, respectively (p = 1.000). The success rates of video-assisted thoracoscopic surgery in both groups were 100% without transthoracic surgery. The post-localization complication rates in the hook wire group and coil group were 36.9 and 32.9% (p = 0.568), and the postoperative complication rates in the hook wire and coil groups were 13.9 and 11.8%, respectively (p = 0.672). Conclusions: Preoperative localization of GGNs with both hook wire and coil methods proved to be useful and effective. Both methods have acceptable preoperative and postoperative complication rates, but the localization and operation times were shorter for the hook wire group than the coil group. Advances in knowledge: Most of previous articles studied a single preoperative localization method. Few studies have compared the preoperative and postoperative methods for metal markers. This paper compared two preoperative localization methods for GGNs to provide clinical guidance.

The Risk Factors For The Failure of Hook Wire Localization of Ground Glass Nodules Prior To Thoracoscopic Surgery

“…A variety of preoperative markers for GGNs prior to VATS have been reported, including hook wire [4,13],…”

“…A variety of preoperative markers for GGNs prior to VATS have been reported, including hook wire [4,13], coil [14,15], methyl blue[16], 99mTc [17], hydrogel plugs[18], barium [8,9], and ducial marker [8,19]. Because of its high feasibility and usability, hook wire is the most widely used marker in preoperative localization.…”

“…Hook wire is one of the most commonly used preoperative markers that has a high success rate [4,7,8]. However, there are still risks of localization failure, such as dislodgement or displacement [9,10], which likely affect the precise removal of pulmonary nodules in thoracoscopic surgery.…”

“…Early resection of pulmonary ground glass nodules (GGNs) with malignant signs can improve the survival rate of patients[ [1]]. Video-assisted thoracoscopic surgery (VATS) is a recognized and effective option to resect malignant GGNs early, and has been widely applied given that it is less invasive than traditional open thoracotomy [ [2][3][4]]. Because of the soft texture of GGNs, it is di cult for thoracic surgeons to touch the nodules with their ngers [5].…”

An update on CT screening for lung cancer: the first major targeted cancer screening programme

“…It is not clear which of these or other procedures are the most effective and safe. [44][45][46][47][48] The majority of comparative trials show them to be equivalent with possibly more side-effects from wire insertion but a shorter surgical time. 45,49 Most of the comparative trials have been in the context of localising small subsolid lesions where resection is often not indicated unless the lesion is part-solid and growing.…”