Simultaneous preoperative computed tomography-guided microcoil localizations of multiple pulmonary nodules

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Imaging

Background:

• Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for pulmonary nodule resection.
• Accurate preoperative localization of pulmonary nodules is crucial for successful VATS.
• Microcoil localization guided by computed tomography (CT) is an established technique for nodule identification.

Purpose of the Study:

• To assess the feasibility and safety of performing simultaneous multiple microcoil localizations for multiple pulmonary nodules.
• To compare complication rates between simultaneous multiple and single microcoil localizations prior to VATS.

Main Methods:

• Retrospective cohort study of 288 patients undergoing CT-guided microcoil localization and VATS.
• Comparison of a multiple localization group (36 patients, 79 nodules) with a single localization group (252 patients, 252 nodules).
• Analysis of technical success and complication rates (pneumothorax, pulmonary hemorrhage) using statistical tests.

Main Results:

• Technical success rates were high in both groups (96.2% for multiple, 98.0% for single).
• The overall complication rate was significantly higher in the multiple localization group (55.6%) compared to the single localization group (21.8%).
• A significantly higher incidence of pneumothorax was observed in the multiple localization group (p < 0.001).

Conclusions:

• Simultaneous preoperative CT-guided microcoil localization of multiple pulmonary nodules is clinically feasible and safe.
• While technically successful, the procedure is associated with an increased risk of pneumothorax.
• This technique offers a viable option for localizing multiple nodules before VATS, with careful consideration of potential complications.