Application Value Of CT-guided Hookwire Positioning Hook In Surgical Intervention Of Pulmonary Nodules

Objective: Lung cancer is a very harmful malignant cancer cell,its incidence and death rate are increasing rapidly [1],and it is also listed as the cause of death of male cancer.Although the causes of lung cancer are not fully understood,a large number of studies have shown that long-term heavy smoking may be closely related to the development of lung cancer.Lung cancer can be divided into various types,including squamous cell carcinoma,adenocarcinoma,large cell carcinoma,small cell carcinoma and lung adeno-squamous cell carcinoma.The surgical treatment effect of small cell lung cancer is poor,and the main treatment methods in China are radiotherapy combined with chemotherapy.For non-small cell lung cancer,surgery is the main means of cure.Isolated pulmonary nodules(SPNS)are single pulmonary nodules without atractasis,hilar lymph node enlargement,or pleural effusion [2-4].In order to resect the lesion,how to locate isolated pulmonary nodules(SPNS)as early as possible becomes the key.Small and deep pulmonary nodules,less than 10 mm in diameter or more than 5 mm from the pleural surface,can lead to a referral rate of up to 63% [5].Video-assisted thoracoscopic surgery(VATS)has become a useful minimally invasive tool for the diagnosis and treatment of SPN [5,6,7].hookwire preoperative can improve the success rate of surgery and prognosis.The purpose of this paper is to explore the advantages and disadvantages of using hookwire in thoracoscopic determination of SPN,as well as possible postoperative complications.Method:We reviewed 84 patients from the Department of Thoracic Surgery of Xinjiang Uygur Autonomous Region People’s Hospital and the Third People’s Hospital of Xinjiang Uygur Autonomous Region from January 2017 to December 2022,and evaluated factors such as preoperative positioning time,positioning success rate,operation time,intraoperative blood loss,postoperative complications,type of SPN lesions,and conversion rate to thoracectomy.In order to better evaluate the advantages and disadvantages of hookwire localization in spn resection and to prevent postoperative complications.After a comprehensive assessment,we found some risk factors for positioning operations.Chi-square test was used for single factor assessment,and the result showed that p value less than 0.05 was significant.Multivariate Logistic regression analysis was also performed.Results: The results showed that 1 case failed to locate the operation,14 cases had pneumothorax,2 cases had chest wall bleeding,1 case had more bleeding,and 2 cases switched to thoracotomy.There were no serious complications such as pleural reaction or shock.After thoracoscopic surgery guided by CT-Hookwire positioning,postoperative pathological results showed: atypical hyperplasia in 8cases,adenocarcinoma in situ in 16 cases,benign nodules in 9 cases,invasive adenocarcinoma in 43 cases,microinvasive adenocarcinoma in 3 cases,pulmonary tuberculosis in 11 cases.Conclusion: Hookwire localization under CT guidance before surgery has the advantages of accurate location of nodules,fewer complications and shorter operation time.