Usefulness of CT-guided hookwire marking before video-assisted thoracoscopic surgery for small pulmonary lesions

Kazushi Suzuki, Masashi Shimohira, Takuya Hashizume, Yoshiyuki Ozawa, Ryoji Sobue, Mikio Mimura, Yuji Mori, Hidenori Ijima, Kenichi Watanabe, Motoki Yano, Hiromu Yoshioka, Yuta Shibamoto

Research output: Contribution to journalArticlepeer-review

53 Citations (Scopus)

Abstract

Materials and Methods This procedure was performed on 161 lesions in 154 patients (75 men and 79 women; median age, 62 years; age range 23-89 years). Medical records and images were reviewed, and the technical success rate, surgical success rate and complications were evaluated. Technical success was defined as successful hookwire marking at the target site without marker dropping before VATS. Surgical success was defined as negative surgical margins on pathological examination after VATS.

Purpose The aim of this study was to evaluate the technical and clinical efficacy and safety of CT-guided hookwire marking before video-assisted thoracoscopic surgery (VATS) for small pulmonary lesions.

Results There were 97 nodules and 64 ground-glass opacities, and their mean size was 9.8 mm (range 2-34). The technical success rate was 97.5% (157/161). In three of the four failed cases, another hookwire marker was placed, and in the remaining case, VATS was performed without a marker. The surgical success rate was 98.1% (158/161). In the three failed cases, the margin was positive, so lung lobectomy was performed in one case, and the other two cases were observed carefully. Complication rates were as follows: pneumothorax, 37.9% (61/161); focal intrapulmonary haemorrhage, 34.8% (58/139); haemoptysis, 0.6% (1/161); haemothorax, 0% (0/161); air embolism, 0.6% (1/161); dissemination, 0% (0/161); and death, 0% (0/161).

Conclusion CT-guided hookwire marking appears to be useful for VATS, but the procedure may, although rarely, cause severe complications such as air embolism.

Original languageEnglish
Pages (from-to)657-662
Number of pages6
JournalJournal of Medical Imaging and Radiation Oncology
Volume58
Issue number6
DOIs
Publication statusPublished - 01-12-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

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