Pre-operative localization of solitary pulmonary nodules with computed tomography-guided hook wire: report of 181 patients

• DOI: 10.1186/s13019-016-0404-4
• Publication Date: 2016-01-15T21:02:25Z
• Authors: Matthieu Hanauer; Jean Yannis Perentes; Thorsten Krueger; Hans-Beat Ris; Pierre Bize; Sabine Schmidt; Michel Gonzalez
• Keywords: Thoracotomy; Cardiothoracic surgery; Wedge resection; Video-assisted thoracoscopic surgery; Solitary pulmonary nodule; Nodule (geology); Hook

Video-assisted thoracic surgery (VATS) is currently performed to diagnose and treat solitary pulmonary nodules (SPN). However, the intra-operative identification of deep can be challenging with VATS as lung difficult palpate. The aim study was report utility results pre-operative computed tomography (CT)-guided hook wire localization SPN.All records patients undergoing CT-guided prior resection for SPN between 2002 2013 were reviewed. efficacy in localizing nodule, complications, necessity convert thoracotomy histology are reported.One hundred eighty-one (90 females, mean age 63 y, range 28-82 y) underwent 187 resections after localization. diameter 10.3 mm (range: 4-29 mm). distance lesion from pleural surface 11.6 0-45 time interval insertion 224 min (range 54-622 min). Hook complications included pneumothorax requiring chest tube drainage 4 (2.1%) mild parenchymal haemorrhage 11 (5.9%) patients. Migration occurred 7 (3.7%) although it did not affect success (nodule location guided by puncture site). Three additional wedge during same procedure because no identified surgical specimen. Conversion required 13 (7 %) centrally localized lesions (6 patients) adhesions patients). operative 60 18-135 Pathological examination revealed a malignant 107 (59 %). diagnostic yield 98.3 %.VATS safe allows proper diagnosis low conversion rate.