Video-assisted thoracoscopic surgical wedge resection using multiplanar computed tomography...

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Diagnostic Imaging

Background:

• Anatomical resection via VATS or robotic lobectomy is standard for early-stage lung cancer.
• Nonanatomical wedge resection (WR) for pulmonary nodule diagnosis can be challenging during VATS or RATS.
• CT-guided microcoil localization combined with multiplanar CT reconstruction (CT MPR)-fluoroscopy is explored for VATS WR.

Purpose of the Study:

• To evaluate the safety and effectiveness of VATS WR using CT MPR-fluoroscopy after CT-guided microcoil localization.
• To assess the feasibility of achieving complete pulmonary nodule resection with this technique.

Main Methods:

• Retrospective review of 130 patients undergoing CT-guided microcoil localization for suspicious malignant pulmonary nodules from January 2016 to December 2020.
• VATS WR was performed with CT MPR and intraoperative fluoroscopy.
• Patients who underwent CT-guided localization and VATS WR were analyzed.

Main Results:

• Successful CT-guided localization in all 130 patients.
• VATS WR success rate was 98.5% with CT MPR-intraoperative fluoroscopy.
• Low postoperative complication rate (3.1%) with no major complications; mean hospital stay was 4.7 days.

Conclusions:

• VATS WR with CT MPR-fluoroscopy after CT-guided microcoil localization is a safe and effective method for complete pulmonary nodule resection.
• This technique addresses challenges in localizing nonvisible, nonpalpable nodules during VATS or RATS.
• Satisfactory outcomes are expected for suspicious malignant pulmonary nodule resection using this approach.