A retrospective study on pre-operative CT-guided hook-wire localization of pulmonary nodules

The Background Currently, surgical resection of the small and sub-centimeter pulmonary nodules (< 2 cm) is quite challenging via the thoracoscopic procedure. Our retrospective study aimed to evaluate the clinical efficiency of pre-operative CT-guided hook-wire localization of targeted pulmonary nodule patients prior to video-assisted thoracoscopic surgery (VATS) or surgery.

60 patients comprising pre-operative computed tomography (CT)-guided hook-wire localization of pulmonary nodules with < 2 cm diameter were retrospectively enrolled. Herein, we evaluated clinical variables, pathological outcomes, hook-wire localization procedure-related features, and complications from targeted pulmonary nodules patients.

Pre-operative CT-guided hook-wire localization was carried out successfully in 60 (100%) patients with wedge resection 41 (68%), segmentectomy 10 (16.7%), and lobectomy 9 (15%). Hook-wire localization procedure had mean time of 0.91±0.29 h, and 11 (18.3%) blood loss. All pulmonary nodule patients were positive pathological diagnoses for benign or malignant lesions, such as 5 (8.3%) benign lesions, 29 (48.3%) minimal adenocarcinoma (MIA) or invasive adenocarcinoma (IAC), and 21 (33.3%) adenocarcinoma in situ (AIS) malignant lesions. The majority of patients with hook-wire localization were either asymptomatic 19 (31.7%) or shown to have mild pain 25 (41.7%) and irritable cough 7 (11.7%).

Preoperative CT-guided hook-wire localization of pulmonary nodules is safe and effective, which can reduce the operative time of targeted pulmonary nodules, and improvise the safety and outcomes of surgery.