Localization of nonpalpable pulmonary nodules using CT-guided needle puncture

摘要

Background Surgical resection of small pulmonary nodule is challenging via thoracoscopic procedure. We describe our experience of computed tomography (CT)-guided needle puncture localization of indeterminate pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS). Methods From January 2011 to July 2014, 78 consecutive patients underwent CT-guided marking for the localization of 91 small pulmonary nodules. We retrospectively reviewed the clinical data, technical details, surgical findings and pathologic results, and complications associated with CT-guided localization. Results Seventy-eight consecutive patients (36 men and 42 women) underwent CT-guided marking localization of 91 indeterminate pulmonary nodules (62 pure ground-glass opacity nodules, 27 part-solid nodules, and 2 solid nodules). The mean size of the nodules was 8.6?mm (3.0–23.0?mm). The mean pleural distance between the nodule and lung surface was 11.5?mm (3.0–31.3?mm). The mean procedure time of CT-guided localization was 15.2?min (8–42 min). All patients stood the procedures well without requiring conversion to open thoracotomy. Twenty-four patients (30.77?%) developed pneumothorax after the procedures. Only one patient required retention of the puncture needle introducer for air drainage. The mean visual assessment pain score was 1.7 (0–3). Fifty-seven nodules (62.63?%) were confirmed as malignances, including 45 primary lung cancer, and 34 nodules (37.37?%) were confirmed as benign lesions. Conclusions CT-guided needle puncture can be an effective and safe procedure prior to VATS, enabling accurate resection and diagnosis of small pulmonary nodules.