Computed tomography-guided preoperative semi-rigid hook-wire localization of small pulmonary nodules: 74 cases report

Zhao, Guang Sheng; Yu, Xin; Chen, Weiqiang; Geng, Guannan; Li, Ning; Li, Hongming; Pan, Yin; Sun, Long; Jiang, Jie

doi:10.1186/s13019-019-0958-z

Cited by 19 publications

(17 citation statements)

References 25 publications

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“…Concerning the hook-wire methods, there have been reports of instances when a hook-wire localization needle was found to be displaced or even fall off during the operation ( 28 , 29 ). Approximately 2.5-13% of pulmonary nodules located by hook-wire may be displaced or even decoupled ( 30 , 31 ). In our previous study, the hook-wire dislodgement rate was 2.5% ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of hook-wire and medical glue for CT-guided preoperative localization of pulmonary nodules

et al. 2022

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BackgroundPreoperative localization is challenging due to the small diameter of pulmonary nodules or their deep location in the lung parenchyma during VATS surgery. The purpose of this study was to compare the efficacy and safety of both hook-wire and medical glue for pre-operative localization of pulmonary nodules.MethodsIn the current study, 158 patients were retrospectively analyzed (January 2019 and January 2020). The patients underwent hook-wire or medical glue for pre-operative localization of pulmonary nodules. Among them, 74 patients in the hook-wire group and 84 patients in the medical glue group underwent VATS anatomic segmentectomy or wedge resection after localization of pulmonary nodules. Pre-operative localization data from all patients were compiled. Moreover, the efficacy and safety of the two methods were evaluated according to localization success rates and localization-related complications.ResultsThe success rate of localization in the medical glue group was 100% while 97.3% in the hook-wire group. After localization of the pulmonary nodules, the incidence of minor pneumothorax in the medical glue group (11.9%) was lower than that in the hook-wire group (37.8%) (p=0.01). The incidence of mild pulmonary parenchymal hemorrhage in the medical glue group (13.1%) was also lower than that in the hook-wire group (24.3%) (p=0.000). The mean time from the completion of localization to the start of surgery was also longer in the medical glue group than in the hook-wire group (p=0.000). The mean visual analog scale (VAS) scores after localization were higher in the hook-wire group than in the medical glue group (p=0.02). In both groups, parenchymal hemorrhage was significantly associated with the needle length in hook-wire localization and the depth of the medical glue in the lung parenchyma (p = 0.009 and 0.001, respectively).ConclusionThese two localization methods are safe and effective in pre-operative pulmonary nodule localization. The medical glue localization method had a lower risk of complications, a higher localization success rate, less pain after localization and more flexibility in the arrangement of operation time.

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Section: Discussionmentioning

confidence: 99%

Comparison of hook-wire and medical glue for CT-guided preoperative localization of pulmonary nodules

et al. 2022

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“…A sufficient margin distance is an important criterion for ensuring a negative margin (no residue under the microscope). In recent years, preoperative positioning technology for small lung tumors and pulmonary nodules has progressed greatly, thus, making it easier to determine the intraoperative margin distance of sublobar resection [ 20 – 23 ]. However, there are no reports on the margin distance that is required to obtain the most reliable negative margin in patients with peripheral lung adenocarcinoma with tumor sizes ≤2 cm who are undergoing sublobar resection.…”

Section: Discussionmentioning

confidence: 99%

Optimal margins for early stage peripheral lung adenocarcinoma resection

et al. 2021

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Background A pathologically confirmed negative margin is required when performing sublobar resection in patients with early stage peripheral lung adenocarcinoma. However, the optimal margin distance to ensure complete tumor resection while preserving healthy lung tissue remains unknown. We aimed to establish a reliable distance range for negative margins. Methods A total of 52 intraoperative para-cancer tissue specimens from patients with peripheral lung adenocarcinoma with pathological tumors ≤2 cm in size were examined. Depending on the distance from the tumor edge (D), the para-cancer tissues were divided into the following five groups: D < 0.5 cm (group I); 0.5 cm ≤ D < 1.0 cm (group II); 1.0 cm ≤ D < 1.5 cm (group III); 1.5 cm ≤ D < 2.0 cm (group IV); and D ≥ 2.0 cm (group V). During pathological examination of the specimens under a microscope, the presence of atypical adenomatous hyperplasia or more severe lesions was considered unsafe, whereas the presence of normal lung tissue or benign hyperplasia was considered safe. Results Group V, in which the margin was the farthest from the tumor edge, was the safest. There were significant safety differences in between groups I and V (χ2 = 26.217, P < 0.001). Significant safety differences also existed between groups II and V (χ2 = 9.420, P < 0.005). There were no significant safety differences between group III or IV and group V (P = 0.207; P = 0.610). Conclusions We suggest that when performing sublobar resection in patients with early stage peripheral lung adenocarcinoma with pathological tumor sizes ≤2 cm, the resection margin distance should be ≥1 cm to ensure a negative margin.

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“…Massive air embolism is a rare complication that has sporadically been described in case reports and with a rate of 0.6% in a large case series (14). Hook wire dislodgement occurs in 2.5-13% of cases (15,16). Hook wire dislodgement occurs in three situations.…”

Section: Hook Wirementioning

confidence: 99%

Perioperative identifications of non-palpable pulmonary nodules: a narrative review

et al. 2021

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Early detection of lung cancer is the key to improving treatment and prognosis of this disease, and the advent of advances in computed tomography (CT) imaging and national screening programs have improved the detection rate of very small pulmonary lesions. As such, the management of this subcentimetric and often sub-solid lesions has become quite challenging for clinicians, especially for choosing the most suitable diagnostic method. In clinical practice, to fulfill this diagnostic yield, transthoracic needle biopsy (TTNB) is often the first choice especially for peripheral nodules. For lesions for which TTNB could present technical difficulties or failed, other diagnostic strategies are needed. In this case, videoassisted thoracic surgery (VATS) is the gold standard to reach the diagnosis of lung nodules suspect of being malignant. Nonetheless it's often not easy the identification of such lesions during VATS because of their little dimensions, non-firm consistency, deep localization. In literature various marking techniques have been described, in order to improve intraoperative nodules detection and to reduce conversion rate to thoracotomy: CT-guided hookwire positioning, methylene blue staining, intra-operative ultrasound and electromagnetic navigation bronchoscopy are the most used. The scientific evidence on this matter is weak because there are no randomized clinical trials but only case series on single techniques with no comparison on efficacy, so there are no guidelines to refer. From this standing, in this article we conducted a narrative review of the existing literature on the subject, with the aim of outlining a framework as complete as possible.We analyzed strengths and weaknesses of the main techniques reported, so as to allow the clinician to orient himself with greater ease.

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Computed tomography-guided preoperative semi-rigid hook-wire localization of small pulmonary nodules: 74 cases report

Cited by 19 publications

References 25 publications

Comparison of hook-wire and medical glue for CT-guided preoperative localization of pulmonary nodules

Comparison of hook-wire and medical glue for CT-guided preoperative localization of pulmonary nodules

Optimal margins for early stage peripheral lung adenocarcinoma resection

Perioperative identifications of non-palpable pulmonary nodules: a narrative review

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