Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Department of Oncology Comprehensive Treatment, The Second Hospital of Chifeng, Chifeng, Inner Mongolia, China.
Eur Radiol. 2022 Jul;32(7):4699-4706. doi: 10.1007/s00330-022-08597-7. Epub 2022 Mar 10.
To evaluate the efficacy and safety of marking ground glass nodules (GGNs) with pulmonary nodules localization needle (PNLN) prior to video-assisted thoracoscopic surgery (VATS).
From June 2020 to February 2021, all patients with GGNs who received CT-guided localization using PNLN before VATS were enrolled. Clinical and imaging data were retrospectively analyzed.
A total of 352 consecutive patients with 395 GGNs were included in the study. The mean diameter of GGNs was 0.95 ± 0.48 cm, and the shortest distance from nodules to the pleura was 1.73 ± 0.96 cm. All 395 GGNs were marked using PNLNs. The time required for marking was 7.8 ± 2.2 min. The marking success rate was 99.0% (391/395). The marking failure of four nodules was all due to the unsatisfactory position of PNLNs. No marker dislocation occurred. Marking-related complications included pneumothorax in 63 cases (17.9%), hemorrhage in 34 cases (9.7%), and hemoptysis in 6 cases (1.7%). All the complications were minor and did not need special treatment. Localization and VATS were performed on the same day in 95 cases and on different days in 257 cases. All GGNs were successfully removed by VATS. No patient converted to thoracotomy. Histopathological examination revealed 74 (18.7%) benign nodules and 321 (81.3%) malignant nodules.
It is safe and reliable to perform preoperative localization of GGNs using PNLNs, which can effectively guide VATS to remove GGNs.
• Preoperative localization of GGNs could effectively guide VATS to remove GGNs. • PNLN was based on the marking principle of hook-wire, through the improvement of its material, specially designed to mark pulmonary nodules. • The application of PNLN to mark GGNs had high success rate, good patient tolerance, and no dislocation. Meanwhile, VATS could be performed 2 to 3 days after marking GGNs with PNLN.
评估在电视辅助胸腔镜手术（VATS）前使用肺结节定位针（PNLN）标记磨玻璃结节（GGN）的疗效和安全性。
本研究纳入了 2020 年 6 月至 2021 年 2 月期间所有接受 CT 引导下 PNLN 定位后行 VATS 的 GGN 患者。回顾性分析了临床和影像学数据。
共纳入 352 例 395 个 GGN 患者。GGN 的平均直径为 0.95±0.48cm，结节至胸膜的最短距离为 1.73±0.96cm。所有 395 个 GGN 均使用 PNLN 标记。标记时间为 7.8±2.2min。标记成功率为 99.0%（391/395）。标记失败的 4 个结节均因 PNLN 位置不理想所致。无标记移位发生。标记相关并发症包括气胸 63 例（17.9%）、出血 34 例（9.7%）和咯血 6 例（1.7%）。所有并发症均较轻，无需特殊治疗。95 例于同一天行定位和 VATS，257 例于不同日进行。所有 GGN 均成功通过 VATS 切除。无患者转为开胸手术。组织病理学检查显示 74 个（18.7%）为良性结节，321 个（81.3%）为恶性结节。
使用 PNLN 对 GGN 进行术前定位安全可靠，可有效指导 VATS 切除 GGN。
