Comparative Effectiveness and Safety of Preoperative Lung Localization for Pulmonary Nodules: A Systematic Review and Meta-analysis

Chul Hwan Park, Kyunghwa Han, Jin Hur, Sang Min Lee, Ji Won Lee, Sung Ho Hwang, Jae Seung Seo, Kye Ho Lee, Woocheol Kwon, Tae Hoon Kim, Byoung Wook Choi

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background An optimal method of preoperative localization for pulmonary nodules has yet to be established. This systematic review and meta-analysis aimed to compare the success and complication rates associated with three pulmonary nodule localization methods for video-assisted thoracoscopic surgery (VATS): hook-wire localization, microcoil localization, and lipiodol localization. Methods We searched the PubMed, MEDLINE, and EMBASE databases for prospective or retrospective English language studies of VATS localization in adult patients. A noncomparative, random effects model–based meta-analysis was performed to obtain pooled success and complication rates for the three localization methods. Results A total of 46 clinical studies were enrolled, including 30, 9, and 7 studies of hook-wire, microcoil, and lipiodol localization, respectively. The successful targeting rates for hook-wire, microcoil, and lipiodol localization were 0.98 (95% CI, 0.97-0.99), 0.98 (95% CI, 0.96-0.99), and 0.99 (95% CI, 0.98-1.00), respectively, with corresponding successful operative field targeting rates of 0.94 (95% CI, 0.91-0.96), 0.97 (95% CI, 0.95-0.98), and 0.99 (95% CI, 0.98-1.00), respectively. In addition, the successful VATS rates with hook-wire, microcoil, and lipiodol localization were 0.96 (95% CI, 0.94-0.97), 0.97 (95% CI, 0.94-0.99), and 0.99 (95% CI, 0.98-1.00), respectively. Regarding complications, hook-wire, microcoil, and lipiodol localization were associated with pneumothorax rates of 0.35 (95% CI, 0.28-0.43), 0.16 (95% CI, 0.07-0.34), and 0.31 (95% CI, 0.20-0.46), respectively and hemorrhage rates of 0.16 (95% CI, 0.11-0.23), 0.06 (95% CI, 0.03-0.11), and 0.12 (95% CI, 0.05-0.23), respectively. Conclusions All three localization methods yielded similarly highly successful targeting rates. However, hook-wire localization had a relatively lower successful operative field targeting rate because of dislodgement or migration. Lipiodol localization had the highest overall success rate, and microcoil localization yielded the lowest complication rates.

Original languageEnglish
Pages (from-to)316-328
Number of pages13
JournalChest
Volume151
Issue number2
DOIs
Publication statusPublished - 2017 Feb 1

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Ethiodized Oil
Meta-Analysis
Safety
Video-Assisted Thoracic Surgery
Lung
Pneumothorax
PubMed
MEDLINE
Language
Databases
Hemorrhage

Keywords

  • hook-wire
  • lipiodol
  • localization
  • lung nodule
  • microcoil

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Comparative Effectiveness and Safety of Preoperative Lung Localization for Pulmonary Nodules : A Systematic Review and Meta-analysis. / Park, Chul Hwan; Han, Kyunghwa; Hur, Jin; Lee, Sang Min; Lee, Ji Won; Hwang, Sung Ho; Seo, Jae Seung; Lee, Kye Ho; Kwon, Woocheol; Kim, Tae Hoon; Choi, Byoung Wook.

In: Chest, Vol. 151, No. 2, 01.02.2017, p. 316-328.

Research output: Contribution to journalArticle

Park, CH, Han, K, Hur, J, Lee, SM, Lee, JW, Hwang, SH, Seo, JS, Lee, KH, Kwon, W, Kim, TH & Choi, BW 2017, 'Comparative Effectiveness and Safety of Preoperative Lung Localization for Pulmonary Nodules: A Systematic Review and Meta-analysis', Chest, vol. 151, no. 2, pp. 316-328. https://doi.org/10.1016/j.chest.2016.09.017
Park, Chul Hwan ; Han, Kyunghwa ; Hur, Jin ; Lee, Sang Min ; Lee, Ji Won ; Hwang, Sung Ho ; Seo, Jae Seung ; Lee, Kye Ho ; Kwon, Woocheol ; Kim, Tae Hoon ; Choi, Byoung Wook. / Comparative Effectiveness and Safety of Preoperative Lung Localization for Pulmonary Nodules : A Systematic Review and Meta-analysis. In: Chest. 2017 ; Vol. 151, No. 2. pp. 316-328.
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abstract = "Background An optimal method of preoperative localization for pulmonary nodules has yet to be established. This systematic review and meta-analysis aimed to compare the success and complication rates associated with three pulmonary nodule localization methods for video-assisted thoracoscopic surgery (VATS): hook-wire localization, microcoil localization, and lipiodol localization. Methods We searched the PubMed, MEDLINE, and EMBASE databases for prospective or retrospective English language studies of VATS localization in adult patients. A noncomparative, random effects model–based meta-analysis was performed to obtain pooled success and complication rates for the three localization methods. Results A total of 46 clinical studies were enrolled, including 30, 9, and 7 studies of hook-wire, microcoil, and lipiodol localization, respectively. The successful targeting rates for hook-wire, microcoil, and lipiodol localization were 0.98 (95{\%} CI, 0.97-0.99), 0.98 (95{\%} CI, 0.96-0.99), and 0.99 (95{\%} CI, 0.98-1.00), respectively, with corresponding successful operative field targeting rates of 0.94 (95{\%} CI, 0.91-0.96), 0.97 (95{\%} CI, 0.95-0.98), and 0.99 (95{\%} CI, 0.98-1.00), respectively. In addition, the successful VATS rates with hook-wire, microcoil, and lipiodol localization were 0.96 (95{\%} CI, 0.94-0.97), 0.97 (95{\%} CI, 0.94-0.99), and 0.99 (95{\%} CI, 0.98-1.00), respectively. Regarding complications, hook-wire, microcoil, and lipiodol localization were associated with pneumothorax rates of 0.35 (95{\%} CI, 0.28-0.43), 0.16 (95{\%} CI, 0.07-0.34), and 0.31 (95{\%} CI, 0.20-0.46), respectively and hemorrhage rates of 0.16 (95{\%} CI, 0.11-0.23), 0.06 (95{\%} CI, 0.03-0.11), and 0.12 (95{\%} CI, 0.05-0.23), respectively. Conclusions All three localization methods yielded similarly highly successful targeting rates. However, hook-wire localization had a relatively lower successful operative field targeting rate because of dislodgement or migration. Lipiodol localization had the highest overall success rate, and microcoil localization yielded the lowest complication rates.",
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T1 - Comparative Effectiveness and Safety of Preoperative Lung Localization for Pulmonary Nodules

T2 - A Systematic Review and Meta-analysis

AU - Park, Chul Hwan

AU - Han, Kyunghwa

AU - Hur, Jin

AU - Lee, Sang Min

AU - Lee, Ji Won

AU - Hwang, Sung Ho

AU - Seo, Jae Seung

AU - Lee, Kye Ho

AU - Kwon, Woocheol

AU - Kim, Tae Hoon

AU - Choi, Byoung Wook

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background An optimal method of preoperative localization for pulmonary nodules has yet to be established. This systematic review and meta-analysis aimed to compare the success and complication rates associated with three pulmonary nodule localization methods for video-assisted thoracoscopic surgery (VATS): hook-wire localization, microcoil localization, and lipiodol localization. Methods We searched the PubMed, MEDLINE, and EMBASE databases for prospective or retrospective English language studies of VATS localization in adult patients. A noncomparative, random effects model–based meta-analysis was performed to obtain pooled success and complication rates for the three localization methods. Results A total of 46 clinical studies were enrolled, including 30, 9, and 7 studies of hook-wire, microcoil, and lipiodol localization, respectively. The successful targeting rates for hook-wire, microcoil, and lipiodol localization were 0.98 (95% CI, 0.97-0.99), 0.98 (95% CI, 0.96-0.99), and 0.99 (95% CI, 0.98-1.00), respectively, with corresponding successful operative field targeting rates of 0.94 (95% CI, 0.91-0.96), 0.97 (95% CI, 0.95-0.98), and 0.99 (95% CI, 0.98-1.00), respectively. In addition, the successful VATS rates with hook-wire, microcoil, and lipiodol localization were 0.96 (95% CI, 0.94-0.97), 0.97 (95% CI, 0.94-0.99), and 0.99 (95% CI, 0.98-1.00), respectively. Regarding complications, hook-wire, microcoil, and lipiodol localization were associated with pneumothorax rates of 0.35 (95% CI, 0.28-0.43), 0.16 (95% CI, 0.07-0.34), and 0.31 (95% CI, 0.20-0.46), respectively and hemorrhage rates of 0.16 (95% CI, 0.11-0.23), 0.06 (95% CI, 0.03-0.11), and 0.12 (95% CI, 0.05-0.23), respectively. Conclusions All three localization methods yielded similarly highly successful targeting rates. However, hook-wire localization had a relatively lower successful operative field targeting rate because of dislodgement or migration. Lipiodol localization had the highest overall success rate, and microcoil localization yielded the lowest complication rates.

AB - Background An optimal method of preoperative localization for pulmonary nodules has yet to be established. This systematic review and meta-analysis aimed to compare the success and complication rates associated with three pulmonary nodule localization methods for video-assisted thoracoscopic surgery (VATS): hook-wire localization, microcoil localization, and lipiodol localization. Methods We searched the PubMed, MEDLINE, and EMBASE databases for prospective or retrospective English language studies of VATS localization in adult patients. A noncomparative, random effects model–based meta-analysis was performed to obtain pooled success and complication rates for the three localization methods. Results A total of 46 clinical studies were enrolled, including 30, 9, and 7 studies of hook-wire, microcoil, and lipiodol localization, respectively. The successful targeting rates for hook-wire, microcoil, and lipiodol localization were 0.98 (95% CI, 0.97-0.99), 0.98 (95% CI, 0.96-0.99), and 0.99 (95% CI, 0.98-1.00), respectively, with corresponding successful operative field targeting rates of 0.94 (95% CI, 0.91-0.96), 0.97 (95% CI, 0.95-0.98), and 0.99 (95% CI, 0.98-1.00), respectively. In addition, the successful VATS rates with hook-wire, microcoil, and lipiodol localization were 0.96 (95% CI, 0.94-0.97), 0.97 (95% CI, 0.94-0.99), and 0.99 (95% CI, 0.98-1.00), respectively. Regarding complications, hook-wire, microcoil, and lipiodol localization were associated with pneumothorax rates of 0.35 (95% CI, 0.28-0.43), 0.16 (95% CI, 0.07-0.34), and 0.31 (95% CI, 0.20-0.46), respectively and hemorrhage rates of 0.16 (95% CI, 0.11-0.23), 0.06 (95% CI, 0.03-0.11), and 0.12 (95% CI, 0.05-0.23), respectively. Conclusions All three localization methods yielded similarly highly successful targeting rates. However, hook-wire localization had a relatively lower successful operative field targeting rate because of dislodgement or migration. Lipiodol localization had the highest overall success rate, and microcoil localization yielded the lowest complication rates.

KW - hook-wire

KW - lipiodol

KW - localization

KW - lung nodule

KW - microcoil

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