Coil Localization-Guided Video-Assisted Thoracoscopic Surgery for Lung Nodules

To determine the clinical efficacy of preoperative coil localization-guided video-assisted thoracoscopic surgery (VATS) for lung nodules.

Between November 2015 and July 2017, 56 patients with lung nodules underwent coil localization-guided VATS procedure. The coil implantation was performed under the guidance of computed tomography (CT). The end tail of the coil remained above the visceral pleura. The target lung nodules were removed by VATS wedge resection. Data on the technical success of coil localization and wedge resection, procedure-related complications, and pathological results were collected and analyzed.

Sixty-seven lung nodules in 56 patients (1.2 nodules/case) were localized. The technical success rate of coil localization was 89.6% (60/67). Sixty-three nodules were localized with one coil and four nodules with two coils. The mean time taken to perform CT-guided coil implantation was 15.7 ± 5.3 (range: 8-40) minutes. Six patients (9.0%) experienced pneumothorax after coil implantation. The technical success rate of wedge resection was 97.0% (65/67). Two nodules were removed directly by video-assisted lobectomy. Nine patients with multiple target lung nodules underwent single-stage resection. The mean total operating time was 147.2 ± 79.1 (range: 50-360) minutes. The mean volume of blood loss was 113.2 ± 113.0 (range: 10-700) mL. Postoperative complications included prolonged air leak (n = 2) and pleural effusion (n = 5).

Preoperative coil localization is a safe and effective method to facilitate a high successful rate of VATS wedge-resection for lung nodules.