Department of Radiology, Peking University People's Hospital, #11 Xizhimen South Avenue, Beijing, China.
Department of Clinical Epidemiology, Peking University People's Hospital, #11 Xizhimen South Avenue, Beijing, China.
Eur Radiol. 2021 Sep;31(9):6539-6546. doi: 10.1007/s00330-021-07772-6. Epub 2021 Mar 5.
To evaluate retrospectively the feasibility and safety of simultaneous multiple microcoil localizations of multiple pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS).
This retrospective cohort study enrolled 288 consecutive patients, who underwent computed tomography (CT)-guided microcoil localization and subsequent VATS at our academic hospital between July 2017 and June 2018. Of these patients, 36 with 79 pulmonary nodules undergoing simultaneous multiple microcoil localizations in the ipsilateral lung were designated the multiple localization group; the remaining 252 with 252 pulmonary nodules undergoing single microcoil localization were designated the single localization group. The main outcomes were the technical success and complication rates of the localization procedures. The Student t test and Mann-Whitney U test were used for continuous variables. The chi-squared test and logistic regression analysis were used to assess dichotomous variables.
The localization technical success rates of the multiple and single localization groups were 96.2% (76/79) and 98.0% (247/252), respectively (p = 0.326). The rate of any complication (pneumothorax or pulmonary hemorrhage) was significantly higher in the multiple localization than in the single localization group (55.6% vs 21.8%, respectively; p < 0.001). The incidence of pneumothorax was significantly higher in the multiple localization than in the single localization group (p < 0.001). The difference between the incidence of pulmonary hemorrhage in the 2 groups was not significant (p = 0.385).
Although preoperative CT-guided simultaneous microcoil localizations of multiple pulmonary nodules produced a significantly higher incidence of pneumothorax, the localizations were clinically feasible and safe.
• Simultaneous preoperative CT-guided microcoil localizations of multiple pulmonary nodules are clinically feasible and safe. • Simultaneous microcoil localizations of multiple pulmonary nodules produced a significantly higher incidence of pneumothorax.
评估术前 CT 引导下多个微线圈对多个肺结节进行同步定位的可行性和安全性，这些肺结节将接受电视辅助胸腔镜手术（VATS）。
本回顾性队列研究纳入了 2017 年 7 月至 2018 年 6 月期间在我院接受 CT 引导下微线圈定位和随后 VATS 的 288 例连续患者。这些患者中，36 例单侧肺部 79 个肺结节进行同步多个微线圈定位，指定为多个定位组；其余 252 例 252 个肺结节进行单个微线圈定位，指定为单个定位组。主要结局是定位程序的技术成功率和并发症发生率。采用学生 t 检验和曼-惠特尼 U 检验比较连续变量，采用卡方检验和逻辑回归分析比较二分类变量。
多个和单个定位组的定位技术成功率分别为 96.2%（76/79）和 98.0%（247/252）（p=0.326）。多个定位组的任何并发症（气胸或肺出血）发生率明显高于单个定位组（55.6%比 21.8%，p<0.001）。多个定位组气胸发生率明显高于单个定位组（p<0.001）。两组肺出血发生率差异无统计学意义（p=0.385）。
尽管术前 CT 引导下对多个肺结节进行同步微线圈定位会导致气胸发生率显著增加，但定位在临床上是可行和安全的。
术前 CT 引导下对多个肺结节进行同步微线圈定位是可行且安全的。
对多个肺结节进行同步微线圈定位会显著增加气胸的发生率。
