Efficacy and complications of computed tomography-guided hook wire localization

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Medical Imaging

Background:

• Video-assisted thoracic surgery (VATS) enables minimally invasive diagnosis and treatment of small pulmonary lesions.
• Accurate localization of small pulmonary lesions can be challenging in VATS.
• Existing localization methods have limited data on efficacy and adverse events.

Purpose of the Study:

• To evaluate the safety, reliability, and convenience of computed tomography (CT)-guided hook wire localization for pulmonary lesions.
• To identify risk factors associated with adverse events during CT-guided hook wire localization.

Main Methods:

• A retrospective study of 417 patients with 500 pulmonary lesions treated between January 2006 and December 2010.
• CT-guided localization using a hook wire was performed for all lesions.
• Data on lesion characteristics, procedure details, and adverse events were collected and analyzed.

Main Results:

• The study successfully localized 178 ground-glass opacity lesions and 322 solid lesions.
• The overall morbidity rate was 15.1%, with pneumothorax requiring aspiration in 4.6% and hemoptysis/pulmonary hematoma in 10.3%.
• Risk factors for pneumothorax included male sex, multiple localizations, and heavy smoking. Insertion distance >25 mm increased risk of hemoptysis and pulmonary hematoma.

Conclusions:

• CT-guided hook wire localization is a safe, reliable, and convenient method for pulmonary lesion localization.
• Lesions with ground-glass opacity components may require larger size and shallower depth for successful localization.
• Insertion distances exceeding 25 mm are linked to an increased risk of pulmonary hematoma and hemoptysis.