[Simple localization of peripheral pulmonary nodules - CT-guided percutaneous hook-wire localization]

Area of Science:

• Thoracic Surgery
• Interventional Radiology
• Pulmonary Medicine

Background:

• Video-assisted thoracoscopic surgery (VATS) offers an alternative for small intrapulmonary nodules when other biopsy methods fail.
• Percutaneous biopsy may be insufficient for precise localization of small pulmonary nodules.
• Accurate localization is crucial for successful minimally invasive thoracic procedures.

Purpose of the Study:

• To investigate the feasibility and effectiveness of CT-guided hook-wire localization for small pulmonary nodules.
• To assess the utility of hook-wire placement as a pre-operative tool for VATS.
• To evaluate the safety and success rate of this localization technique.

Main Methods:

• 19 patients with newly diagnosed intrapulmonary nodules underwent CT-guided hook-wire localization using a specific kit.
• Patient demographics included an average age of 63 years, with nodules averaging 11.58 mm in diameter and located 7.58 mm from the pleura.
• Following localization, VATS resection was performed within an average of 30 minutes.

Main Results:

• Successful resection of pulmonary nodules was achieved in all 19 patients.
• Minor complications included asymptomatic pneumothorax in 8 patients and local bleeding in 4 patients.
• No instances of hook-wire system dislocation were reported, even in cases with challenging localization due to patient cooperation.

Conclusions:

• CT-guided hook-wire placement is a simple, safe, and effective procedure.
• This technique significantly facilitates successful VATS resection of small pulmonary nodules.
• It is a valuable tool for improving the precision of minimally invasive thoracic surgery.