• J. Thorac. Cardiovasc. Surg. · Apr 2020

    Multicenter Study Comparative Study

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

    • Chul Hwan Park, Sang Min Lee, Ji Won Lee, Sung Ho Hwang, Woocheol Kwon, Kyunghwa Han, Jin Hur, and LOGIS investigators.
    • Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
    • J. Thorac. Cardiovasc. Surg. 2020 Apr 1; 159 (4): 1571-1579.e2.

    ObjectivesAccurate 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.MethodsThis 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.ResultsThe 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).ConclusionsThere 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.Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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