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| Clinical application of preoperative CT guided Hook-wire localization in pulmonary nodules difficult detected during video-assisted thoracoscopic surgery |
| GAO De-pei, DONG Xing-xiang, LI Zhen-hui, FENG Jun, TIAN Chuan, ZHANG Da-fu |
| Yunnan Tumor Hospital, the 3rd Affiliated Hospital of Kunming Medical University, Kunming 650118, China |
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Abstract Objective: To explore the clinical value of Hook-wire localization under CT guidance before operation of small pulmonary nodules(≤10 mm), which are difficult to be detected in video-assisted thoracoscopic surgery, and to discuss the necessity and feasibility of active minimally invasive surgery for small nodules. Methods: From December 2017 to June 2018, a total of 45 patients underwent preoperative CT guided Hook-wire(Accura TM BLN 21 ga×10 cm) localization and underwent video assisted thoracoscopic surgery. Results: Forty-five patients(22 males and 23 females) had a total of 45 micro nodules. There were 3 nodules in anterior segment and 3 in apicoposterior segment of left upper lobe, 3 in lateral basal segment and 5 in posterior basal segment of left inferior lobe, 8 in anterior segment, 2 in apical segment and 6 in posterior segment of right upper lobe, 3 in right middle lobe, 4 in dorsal segment, 2 in lateral basal segment, 2 in anterior basal segment, 4 in posterior basal segment of right inferior lobe. There were 13 solid nodules, 22 pure ground-glass nodules and 10 mixed ground-glass nodules. There were 17 nodules with diameter between 5 mm to 10 mm, 28 nodules less than 5 mm. The success rate of Hook-wire guided by CT was 95.56%, and the rate of video assisted thoracoscopic resection was 100%. Histological findings were 25 cases of adenocarcinoma in situ, 8 cases of inflammatory lesions, 12 cases of benign tumors and tumor like lesions. Conclusion: CT guided Hook-wire pulmonary micro nodules location have high accuracy and slight complications before operation. It is helpful to detect and remove the lesion in time, shorten the time of operation, and is beneficial to the early recovery of the patients, and it is worthy of clinical promotion.
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Received: 18 July 2018
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