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Thorac Cardiovasc Surg 2020; 68(06): 533-539
DOI: 10.1055/s-0040-1708471
Original Thoracic

Application of Modified Tailed Microcoil in Preoperative Localization of Small Pulmonary Nodules: A Retrospective Study

Saisai Sun  ‡   *
1   Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
,
Kaichao Liu‡   *
2   Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
,
Xiang Gao
1   Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
,
Binhui Ren
1   Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
,
Lei Sun
3   Department of Interventional Radiology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
,
Lin Xu
1   Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
› Author Affiliations
Funding This research was supported by the National Natural Science Foundation of China (81672869), Jiangsu Provincial Medical Outstanding Talent (Lin Xu) and Jiangsu Provincial Medical Youth Talent (Binhui Ren, QNRC2016657). The talents program of Jiangsu Cancer Hospital YC201814, the “333” talent project: BRA2019325.
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Abstract

Background The localization of small pulmonary nodules (SPNs) during video-assisted thoracoscopic surgery (VATS) is challenging thoracic surgeon, especially in patients with severe pleural adhesion or visceral pleura pigmentation due to low success rate and future conversion to thoracotomy. This study aims to compare the efficacy and safety between modified microcoil and methylene blue in preoperative localization of small nodules, particularly patients with severe pleural adhesion or visceral pleura pigmentation.

Materials and Methods From January 2018 to February 2019 in our institute, 342 patients who underwent computed tomography-guided localization of SPN were recruited in this retrospective cohort study and divided into the modified microcoil group (n = 239) and the methylene blue group (n = 103) according to the localization method. Clinical characteristics and perioperative complications were collected to analyze.

Results All SPNs were successfully marked in both groups. Location-related complications, the duration of localization procedure, and the length of hospital stay were not different between the two groups. The operation time of modified microcoil and the duration of removal of nodule in operation were both shorter than the methylene blue (p = 0.014 and p = 0.047). The analysis stratified by gender showed that similar results were found in male patients (p = 0.01 and p = 0.00), while in female patients, no significant difference was found. Additionally, in senior patients (older than 60 years), the operation time in modified microcoil groups was less than methylene blue group (p = 0.024).

Conclusion Compared with methylene blue, modified microcoil achieved a shorter operation time of removal of nodule in VATS, especially for patients with pleural adhesion and the pigmentation of the lung surface as well as the male patients and the patients older than 60 years.

Keywords

lung cancer - treatment - VATS - computed tomography - CT scan

Authors' Contribution

Study conception and design: Saisai Sun, Kaichao Liu, Binhui Ren, Lin Xu, and Lei Sun.


Acquisition of data: Lei Sun and Xiang Gao.


Analysis and interpretation of data: Xiang Gao.


Drafting of manuscript: Saisai Sun, Kaichao Liu, and Binhui Ren.


Critical revision: Kaichao Liu, Lin Xu, and Lei Sun.


Final approval of the article: All authors.


Authorships

Saisai Sun and Kaichao Liu contributed equally to this work and to the study design; Saisai Sun, Kaichao Liu, and Binhui Ren wrote the manuscript and the rebuttal letter; Saisai Sun, Kaichao Liu, and Lei Sun analyzed and interpreted the data; Lei Sun and Xiang Gao collected all the data. Binhui Ren, Lin Xu, and Lei Sun designed the whole study; Binhui Ren and Lin Xu funded the study; Lei Sun performed the nodule positioning.


* These authors contributed equally to this work.




Publication History

Received: 03 December 2019

Accepted: 14 January 2020

Article published online:
19 June 2020

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