The Application Of Computed Tomography-guided Localization With A Hook-wire System For Pulmonary Ground-glass Opacity Nodules Before Video-assisted Thoracoscopic Resection

Objective: Retrospectively analyse the clinical application of ComputedTomography-guided Localization with a Hook-wire System for Pulmonaryground-glass opacity Nodules before Video-assisted Thoracoscopic Resection, and tosum up the experiences of operation. Discuss the relationship between the lesion’sdistance to nearest pleural surface and the deviation of the hook-wire needle to thelesion. To create a standard for the CT-guided Hook-wire Localization technique.Methods: Hook-wire has been used to localize93GGNs under CT guidance in81patients (28males and53females, ranging from24to77years, average age58years),and wedge resection was performed through VATS. The type of CT scanner is GELightspeed16. Angiotech Accura BLN2110positioning needles were used to localizeGGNs.20cases were mGGOs,73cases were pGGOs. The diameter of GGNs rangedfrom0.29to2.6cm, average diameter is0.88cm. The distance of GGNs to the nearestpleural surface between0.29and4.6cm. Most of GGNs in the peripheral lung.24casesin superior lobe of right lung,10cases in middle lobe of right lung,23cases in inferiorlobe of right lung,18cases in superior lobe of left lung, and18cases in inferior lobe ofleft lung.Measure the distance of93nodules to the nearest pleural surface(X) and tohook-wire needle(Y). Correlation analysis was performed on two groups of data.Results:93cases of Locating operations succeeded respectively. Histologicalexamination revealed that19cases are benign nodules and74cases are malignantground-glass opacity nodules.74cases were adenocarcinomas (10cases were AISs,25cases were MIAs,39cases were invasive adenocarcinomas),5cases were AAHs,2cases were hamartomas, and12cases were inflammations. The major complication ofCT-guided hookwire localization was pneumothorax in44patients，but no one needed chest tube drainage. Wire dislodgement founds in2cases, but VATS was performed bylocalize the hemorrhages on lung surface. Count the values of X、Y、XY、X2and Y2,andfill in a table, and draw a scatter diagram. X and Y show a linear trend. Pearson’sbivariate correlation analysis was performed on two groups of data, we can find that Xand Y was significantly positively correlated（r=0.333，p＜0.05）.Conclusions: Computed Tomography-guided Localization with a Hook-wireSystem for Pulmonary ground-glass opacity Nodules offers a safe and accurate guideduring thoracoscopic resection. Sufficient preoperative preparation and standardizedsurgical procedures play an important role in CT-guided hook-wire localization. Thereis a positive correlation between the lesion’s distance to nearest pleural surface and thedeviation of the hook-wire needle to the lesion, mostly farther distance of the nodule tothe nearest pleural surface lead to farther distance of nodule to hook-wire needle. Webelieve that GGNs which the distance to the nearest pleural surface≤3cm were moresuitable for Computed Tomography-guided Localization with a Hook-wire Systembefore video-assisted thoracoscopic resection.