Advertisement

European Radiology

, Volume 28, Issue 10, pp 4048–4052 | Cite as

Preoperative localisation of pulmonary ground-glass opacity using medical adhesive before thoracoscopic resection

  • Ren-li Cen
  • Fei Cui
  • Qi Wan
  • Ling Chen
  • Xiao-yan Huang
  • Jia-xuan Zhou
  • Shu-ben Li
  • Qing-si Zeng
  • Jian-xing He
Chest
  • 187 Downloads

Abstract

Objectives

To evaluate the safety and efficiency of computed tomography (CT)-guided medical adhesive, α-cyanoacrylate, for preoperative localisation of pulmonary ground-glass opacity (GGO) used for guiding the video-assisted thoracoscopic surgical (VATS) excision

Methods

The procedure was performed on 188 consecutive patients with solitary GGO (pure GGO = 90 cases; mixed GGO = 98 cases) prior to the thoracoscopic procedure. The complications and efficacy of this method were analysed. The resected GGO was analysed pathologically.

Results

The mean duration of the procedure was 16.3 ± 5.2 min. The preoperative localisation was 100% successful. All GGOs were successfully resected by VATS. Asymptomatic pneumothorax was developed in 16/188 patients (8.5%) and mild pulmonary haemorrhage occurred in 15 cases (7.9%) post-localisation. None of the patients required any further treatment for the complications.

Conclusion

Preoperative localisation using CT-guided medical adhesive, α-cyanoacrylate, is a safe and short-duration procedure, with high accuracy and success rates with respect to VATS resection of GGO.

Key Points

• Preoperative localisation is crucial for successful resection of GGO by VATS.

• Preoperative adhesive localisation provides an up to 100% successful localisation rate with few complications.

• Preoperative adhesive localisation enabled VATS resection in 100% of the GGO.

• Preoperative adhesive localisation is safe and effective for VATS resection of GGO.

Keywords

Solitary pulmonary nodule Lung neoplasms Tomography, x-ray computed Tissue adhesives Thoracic surgery, video-assisted 

Abbreviations

GGO

Ground-glass opacity

VATS

Video-assisted thoracoscopic surgery

Notes

Funding

This study has received funding from the Medical Scientific Research Foundation of Guangdong Province, China (A2016410), and National Natural Science Foundation of China (81601457)

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Qingsi Zeng.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

References

  1. 1.
    Moyer VA, Force USPST (2014) Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 160:330–338PubMedGoogle Scholar
  2. 2.
    National Lung Screening Trial Research T, Aberle DR, Adams AM et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409CrossRefGoogle Scholar
  3. 3.
    Shimizu K, Ikeda N, Tsuboi M, Hirano T, Kato H (2006) Percutaneous CT-guided fine needle aspiration for lung cancer smaller than 2 cm and revealed by ground-glass opacity at CT. Lung Cancer 51:173–179CrossRefGoogle Scholar
  4. 4.
    Suzuki K, Nagai K, Yoshida J et al (1999) Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest 115:563–568CrossRefGoogle Scholar
  5. 5.
    Xu X, Yao Y, Shen Y, Zhang P, Zhou J (2015) Clinical analysis of percutaneous computed tomography-guided hook wire localization of 168 small pulmonary nodules. Ann Thorac Surg 100:1861–1867CrossRefGoogle Scholar
  6. 6.
    Huang W, Ye H, Wu Y et al (2014) Hook wire localization of pulmonary pure ground-glass opacities for video-assisted thoracoscopic surgery. Thorac Cardiovasc Surg 62:174–178CrossRefGoogle Scholar
  7. 7.
    Moon SW, Cho DG, Cho KD, Kang CU, Jo MS, Park HJ (2012) Fluoroscopy-assisted thoracoscopic resection for small intrapulmonary lesions after preoperative computed tomography-guided localization using fragmented platinum microcoils. Thorac Cardiovasc Surg 60:413–418CrossRefGoogle Scholar
  8. 8.
    Klijian AS (2016) Agar blue localization of small pulmonary nodules and ground glass opacifications for thoracoscopic resection. J Thorac Dis 8:S677–s680CrossRefGoogle Scholar
  9. 9.
    Park CH, Hur J, Lee SM et al (2015) Lipiodol localization for ground-glass opacity minimal surgery: Rationale and design of the LOGIS trial. Contemp Clin Trials 43:194–199CrossRefGoogle Scholar
  10. 10.
    Kawanaka K, Nomori H, Mori T et al (2009) Marking of small pulmonary nodules before thoracoscopic resection: injection of lipiodol under CT-fluoroscopic guidance. Acad Radiol 16:39–45CrossRefGoogle Scholar
  11. 11.
    Bertolaccini L, Terzi A, Spada E, Acchiardi F, Ghirardo D (2012) Not palpable? Role of radio-guided video-assisted thoracic surgery for nonpalpable solitary pulmonary nodules. Gen Thorac Cardiovasc Surg 60:280–284CrossRefGoogle Scholar
  12. 12.
    Chella A, Lucchi M, Ambrogi MC et al (2000) A pilot study of the role of TC-99 radionuclide in localization of pulmonary nodular lesions for thoracoscopic resection. Eur J Cardiothorac Surg 18:17–21CrossRefGoogle Scholar
  13. 13.
    Lin MW, Chen JS (2016) Image-guided techniques for localizing pulmonary nodules in thoracoscopic surgery. J Thorac Dis 8:S749–s755CrossRefGoogle Scholar
  14. 14.
    Yoshida J, Nagai K, Nishimura M, Takahashi K (1999) Computed tomography-fluoroscopy guided injection of cyanoacrylate to mark a pulmonary nodule for thoracoscopic resection. Jpn J Thorac Cardiovasc Surg 47:210–213CrossRefGoogle Scholar
  15. 15.
    Mayo JR, Clifton JC, Powell TI et al (2009) Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology 250:576–585CrossRefGoogle Scholar
  16. 16.
    Park CH, Han K, Hur J et al (2017) Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: a systematic review and meta-analysis. Chest 151:316–328CrossRefGoogle Scholar
  17. 17.
    Zaman M, Bilal H, Woo CY, Tang A (2012) In patients undergoing video-assisted thoracoscopic surgery excision, what is the best way to locate a subcentimetre solitary pulmonary nodule in order to achieve successful excision? Interact Cardiovasc Thorac Surg 15:266–272CrossRefGoogle Scholar
  18. 18.
    Hu M, Zhi X, Zhang J (2015) Preoperative computed tomography-guided percutaneous localization of ground glass pulmonary opacity with polylactic acid injection. Thorac Cancer 6:553–556CrossRefGoogle Scholar
  19. 19.
    Ohno Y, Hatabu H, Takenaka D et al (2003) CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol 180:1665–1669CrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Ren-li Cen
    • 1
  • Fei Cui
    • 2
  • Qi Wan
    • 1
  • Ling Chen
    • 1
  • Xiao-yan Huang
    • 1
  • Jia-xuan Zhou
    • 1
  • Shu-ben Li
    • 2
  • Qing-si Zeng
    • 1
  • Jian-xing He
    • 2
  1. 1.Department of RadiologyThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
  2. 2.Department of Thoracic SurgeryThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina

Personalised recommendations