Computed Tomography Guided Coil Localization and Uniportal Video-Assisted Thoracic Surgery Resection of Small Lung Lesions

TL;DR

This paper describes a safe and effective method for diagnosing and removing small lung nodules using CT-guided coil localization and minimally invasive surgery.

Contribution

The study demonstrates the combined use of CT-guided coil localization and UVATS for accurate resection of small pulmonary nodules.

Findings

All 67 nodules were successfully resected with negative margins.

Conclusive histological diagnosis was achieved in all cases.

Complications occurred in 3% of patients during the localization procedure.

Abstract

Purpose

We present our experience with computed tomography (CT) guided coil localization of small pulmonary nodules (<1 cm) followed by Uniportal video-assisted thoracic surgery (UVATS) image-guided resection of these lesions.

Method

We present 61 patients who underwent CT-guided coil localization for 67 lung nodules, followed by image-guided UVATS wedge resection of these nodules from March 2015 to May 2019. Coils were placed first under local anaesthetic by interventional radiology before the patient was transferred to the operating theatre and underwent fluoroscopy-guided wedge resection under general anaesthesia.

Results

All cases had successful surgical resection with negative resection margins. Conclusive histological diagnosis was reached in all cases. Two patients (3%) encountered complications from CT-guided coil localization. One suffered a pneumothorax requiring immediate chest drain insertion, and another required conversion to open thoracotomy due to a dislodged coil.

Conclusions

CT-guided coil localization of pulmonary nodules followed by UVATS wedge resection is a fast and safe procedure that accurately diagnoses and treats small pulmonary nodules.

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