Hwang Sangwon, Kim Tae Gyu, Song Yun Gyu
Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Thorac Cancer. 2018 Mar;9(3):384-389. doi: 10.1111/1759-7714.12589. Epub 2018 Jan 11.
A hook wire has been most widely used for computed tomography (CT)-guided localization before video-assisted thoracoscopic surgery (VATS). However, microcoils have been suggested to replace wires. The purpose of this study was to compare the efficacy, VATS procedure time, and excised volume of specimens of CT-guided localization using a hook wire and microcoil.
The medical records of 106 patients with 110 pulmonary nodules who underwent CT-guided localization using a hook wire (group A) or microcoil (group B) before VATS performed between March 2013 and January 2017 were retrospectively reviewed.
The procedure success rate was 100% in both groups. Dislodgement occurred in four patients in group A and not in group B. Patient pain score was significantly lower for group B than group A (4.0 vs. 6.3; P < 0.001). The VATS success rate was higher in group B than in group A (98.1% vs. 91.1%; P = 0.174). The VATS procedure time was significantly shorter for group B than group A (18.8 vs. 23.6 minutes; P = 0.004). The excised volume of surgical specimens was significantly smaller for group B than group A (8.5 vs. 11.7 cm ; P = 0.043). No major complications related to the localization procedure were noted in either group.
This study showed similar effectiveness of VATS localization between groups. However, microcoil is superior to hook wire for localization of pulmonary nodules in terms of VATS procedure time and excised volume of surgical specimens, with the advantages of no dislodgement and less patient pain.
在电视辅助胸腔镜手术（VATS）前，钩丝一直是计算机断层扫描（CT）引导下定位最广泛使用的方法。然而，有人建议用微线圈取代钩丝。本研究的目的是比较使用钩丝和微线圈进行CT引导下定位的疗效、VATS手术时间和标本切除体积。
回顾性分析2013年3月至2017年1月期间106例患有110个肺结节的患者的病历，这些患者在VATS前接受了使用钩丝（A组）或微线圈（B组）的CT引导下定位。
两组的手术成功率均为100%。A组有4例患者出现移位，B组未出现。B组患者的疼痛评分显著低于A组（4.0对6.3；P<0.001）。B组的VATS成功率高于A组（98.1%对91.1%；P = 0.174）。B组的VATS手术时间显著短于A组（18.8对23.6分钟；P = 0.004）。B组手术标本的切除体积显著小于A组（8.5对11.7cm；P = 0.043）。两组均未发现与定位手术相关的重大并发症。
本研究显示两组间VATS定位的有效性相似。然而，就VATS手术时间和手术标本切除体积而言，微线圈在肺结节定位方面优于钩丝，具有不移位和患者疼痛较轻的优点。
