Post-Anesthesia Hookwire Localization of Pulmonary Ground Glass Nodules Guided by Computed-Tomography Three-Dimensional Reconstruction: A Feasibility Study

Abstract

Background: Computed-tomography(CT) guided hookwire localization has disadvantages, such as pain, patient transport risk and increased radiation exposure. In order to overcome the above shortcomings, our method is post-anesthesia hookwire localization guided by preoperative CT three-dimensional reconstruction. The effectiveness and safety of this method will be studied.Methods: A total of 36 patients(36 nodules) with ground glass nodules were consecutively included in this study. Three dimensional reconstruction of chest CT was performed to simulate the puncture path. The puncture point, the depth and angle of needle insertion were recorded. After anesthesia, the puncture point was marked on the patient's body surface. Hookwire was placed according to the previous planned puncture direction and depth. The effectiveness and complications of the localization were evaluated during the operation.Results: Hookwire dislocation was found in 1 patient in operation. The other 35 nodules were successfully positioned. The median distance between hookwire and lesion was 14mm(3-25mm). The effective rate was 97.2%(35/36). Only one patient found a small amount of blood in the chest. There was no pulmonary hematoma, blood pressure or oxygen decreasing in all patients. The complication rate was 2.8% (1/36) and the severe complication was 0. The median time for localization was 3 minutes. Conclusion: Post-anesthesia hookwire localization guided by preoperative three-dimensional reconstruction is a simple, safe and effective localization method, which is suitable for appropriate nodules, and is an important supplement to CT guided localization.Trial registration: ChiCTR1900023853. Registered in Chinese Clinical Trail Registry on 14 June 2019, http://www.chictr.org.cn/showprojen.aspx?proj=40060