Computed tomography‐guided coil localization for video‐assisted thoracoscopic surgery of sub‐solid lung nodules: a retrospective study

Abstract

Background Wedge resection via video‐assisted thoracoscopic surgery (VATS) is the best choice for the diagnosis of sub‐solid lung nodules. Preoperative localization is utilized to increase the success rate of this procedure. We aimed to evaluate the effectiveness of preoperative coil localization in VATS wedge resection for sub‐solid lung nodules. Methods From October 2015 to August 2018, 42 patients with 55 sub‐solid lung nodules underwent computed tomography‐guided coil localization with subsequent VATS wedge resection in our centre. Data regarding visible coil rates, technical success of the wedge resection and pathological results were collected and analysed retrospectively. Results A total of 55 sub‐solid lung nodules were localized in 42 patients. Thirty‐three patients had one nodule and nine patients had multiple nodules. Fifty‐two coils (52/55, 94.5%) were visible during the VATS. The mean duration of each coil localization was 14.3 ± 4.8 min (range 7–40 min). Three patients (7%) experienced pneumothorax after coil localization. VATS wedge resection was successfully performed for 53 nodules (53/55, 96.4%). The remaining two nodules were treated directly with lobectomy. The nine patients who had multiple nodules underwent one‐stage VATS wedge resection of all nodules. The mean duration of the VATS in the 42 patients was 159.3 ± 83.4 min (range 60–360 min) while the mean blood loss was 119.3 ± 115.3 mL (range 10–700 mL). Conclusion Preoperative computed tomography‐guided coil localization is a safe and effective method to facilitate high success rates for diagnostic VATS wedge resection for sub‐solid nodules.

Computed tomography-guided coil localization for sub-fissural lung nodules

“…In addition, the wedge resection instead of lobectomy is performed for patients with lung metastasis. [ 10 ] The median blood loss in this study was only 65 mL, which is comparable to that (50 mL) in a previous study regarding of trans-fissural coil localization for sub-fissural LNs. [ 11 ]…”

“…This is consistent with a prior study that achieved a 91% technical success rate when employing a trans-fissural short hook-wire approach to preoperatively localize LNs. [ 10 ] This result indicated that trans-fissural coil localization for LNs is also technically feasible.…”

“…This finding is comparable to that in the previous studies regarding trans-fissural hook-wire or coil localization for sub-fissural LNs. [ 10 , 11 ]…”

Sublobar Resection Versus Ablation for Stage I Non-Small-Cell Lung Cancer: A Meta-Analysis

“…Non-small-cell lung cancer (NSCLC) is the deadliest form of cancer globally [1][2][3], and many patients with earlystage NSCLC can undergo curative surgical resection following tumor detection via chest computed tomography (CT) screening [4][5][6]. Lobectomy with systematic mediastinal lymphadenectomy is the standard approach to treating stage I NSCLC [7][8][9]. However, in many cases, patients are elderly or have a history of comorbidities such as pulmonary dysfunction or atherosclerosis that may preclude their ability to undergo invasive surgical treatment s [4][5][6].…”

“…While sublobar resection (SR) is generally less effective as a curative procedure relative to lobectomy [4], it can better preserve patient pulmonary function [7][8][9]. In stage I NSCLC patients with tumors ≤ 2 cm in size, SR yields similar survival outcomes to lobectomy [5,6].…”