Department of Thoracic Surgery, Jiangxi Cancer Hospital, No. 519, Beijing East Road, Nanchang, 330029, China.
BMC Pulm Med. 2022 Aug 17;22(1):317. doi: 10.1186/s12890-022-02065-0.
Computed tomography-guided hook wire localization (CT-GHWL) was used to localize the small pulmonary nodules before video-assisted thoracic surgery (VATS). Its associated complications included hook wire dislodgement, pulmonary hemorrhage, and pneumothorax. This is the first report of a patient with a hook wire sliding into the subglottic area after CT-GHWL.
A 27-year-old female had productive cough for 8 days. A high-resolution CT scan showed a 12 mm part-solid nodule in the number 8 segment of the left lung. Prior to VATS, she received CT-GHWL to localize the nodule. During VATS, the hook wire unexpectedly slid away. A chest computed tomography was immediately performed and the sagittal reconstructed images showed the needle at the subglottic area. Finally, the needle was extracted by biopsy forceps under bronchoscope evaluation. The patient was eventually recovered and discharged.
Dislodge of the hook wire into the subglottic area is an extremely rare but serious complication following CT-GHWL. Attention should be paid to securing the needle on the lung surface during VATS.
计算机断层扫描引导钩丝定位（CT-GHWL）用于在电视辅助胸腔镜手术（VATS）前定位小的肺结节。其相关并发症包括钩丝移位、肺出血和气胸。这是首例 CT-GHWL 后钩丝滑入声门下区的病例报告。
一名 27 岁女性因咳嗽 8 天就诊。高分辨率 CT 扫描显示左肺 8 段有一个 12mm 的部分实性结节。在 VATS 之前，她接受了 CT-GHWL 来定位结节。在 VATS 过程中，钩丝意外滑走。立即进行胸部 CT 检查，矢状位重建图像显示针位于声门下区。最终，在支气管镜评估下使用活检钳取出了针。患者最终康复出院。
钩丝滑入声门下区是 CT-GHWL 后一种极其罕见但严重的并发症。在 VATS 过程中应注意将针固定在肺表面。
