Abstract
Background: To evaluate the feasibility and safety of microcoil in simultaneous localization for multiple pulmonary nodules before video-assisted thoracic surgery (VATS). Methods: Twenty-eight consecutive patients (26 two-nodule, 2 three-nodule; totally 58 nodules; Group A) underwent simultaneous CT-guided localization for multiple pulmonary nodules before VATS using microcoil. Successful targeting, localization, and VATS were defined as implantation of microcoil at the target site on CT image obtained immediately after the marking procedure, visualization of nodule location, and complete resection of the target nodule with adequate margin, respectively. Meanwhile, the clinical characteristics, localization procedure-related variables of the nodules and procedure-related complication in group A were also assessed and compared with those in a control group (221 single-localization procedures in 221 patients; Group B). Results: The similar rates of success targeting, localization and VATS were observed in group A and B (96.6% vs 98.2%; 91.4% vs 91.0%; 100% vs 99.1%). Although the rate of overall complications (including localized pneumothorax and intrapulmonary hemorrhage) was a bit higher in group A than that in group B (32.8% vs 30.8%, p =0.771), only minor complications were observed in the subjects of the two groups with no need for further treatment. In addition, the duration of simultaneous localization procedures was significantly longer than that of single localization ones (24±7.5 vs 13±6 min, p <0.001). Conclusions: CT-guided simultaneous microcoil localization for multiple pulmonary nodules before VATS was clinical feasible and safe with acceptable increasing the procedure time. Compared with localization for a single pulmonary nodule, simultaneous microcoil localizations for multiple nodules were prone to the occurrence of pneumothorax and hemorrhage. However, no statistically significant differences were observed between the two groups.
Intraoperative Ultrasound During Video-Assisted Thoracic Surgery for Solitary Pulmonary Nodules