Hook-wire localization versus lipiodol localization for patients with pulmonary lesions having ground-glass opacity

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Abstract

Objectives: Accurate and safe preoperative localization is useful for video-assisted thoracic surgery of small pulmonary lesions with ground-glass opacity (GGO). However, the optimal localization method is unclear. The aim of this study was to compare the usefulness and safety of the lipiodol and hook-wire localization techniques for video-assisted thoracic surgery of GGO lesions. Methods: This prospective, non-randomized comparative study was conducted between April 2014 and December 2016 at 8 qualifying university teaching hospitals. Two-hundred-fifty patients with pulmonary lesions having GGO were included. Patients were assigned in a 1:1 ratio to either the lipiodol (n = 125, 4 hospitals) or hook-wire group (n = 125, 4 hospitals) for preoperative localization procedures. Participants underwent preoperative localization via the lipiodol or hook-wire technique followed by thoracoscopic surgery. The primary endpoint was the procedure success rate. Results: The procedure success rates (hook-wire vs lipiodol group) were 94.40% versus 99.16% (P =.08). Localization-related complications occurred in 53.60% versus 48.33% of patients (P =.49). Hemorrhage rates were significantly greater in the hook-wire group than in the lipiodol group (21.6% vs 5.83%, P <.001). The lipiodol procedure time was significantly longer than that of the hook-wire technique (20.69 ± 9.34 vs 17.15 ± 7.91 minutes, P =.001). The initially positive surgical resection margin was significantly greater in the hook-wire group than in the lipiodol group (10.89% vs 2.38%, P =.02). Conclusions: There was no significant difference in success rate between the hook-wire and lipiodol methods. However, the hemorrhage rate was significantly greater in the hook-wire group, whereas the hook-wire group showed greater initially positive surgical resection margins.

Original languageEnglish
Pages (from-to)1571-1579.e2
JournalJournal of Thoracic and Cardiovascular Surgery
Volume159
Issue number4
DOIs
Publication statusPublished - 2020 Apr

Keywords

  • ground-glass opacity
  • hook-wire
  • lipiodol
  • localization
  • video-assisted thoracic surgery

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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