The British journal of radiology · 2021
Medical adhesive vs hookwire for computed tomography-guided preoperative localization and risk factors of major complications.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ye Weitao, Dong Chenyu, Lin Churong, Wu Qidi, Li Jiao, Zhou Zihao, Wen Menghuang, Liang Changhong, Zhao Zhenjun, Yang Lin
Аннотация
OBJECTIVE: To compare the efficacy of medical adhesive and hookwire as CT-guided non-palpable pulmonary nodule (NPN) localization methods before video-assisted thoracoscopic surgery (VATS) resection, and determine the risk factors for common complications during localization.
METHODS: This was a single-center non-randomized retrospective study. 102 consecutive patients with 109 NPNs were divided into Group A (medical adhesive, 66 patients, 72 nodules) and Group B (hookwire, 36 patients, 37 nodules) before VATS. Patient- and nodule-based characteristics were compared. Logistic regression was performed to identify the risk factors for complications.
RESULTS: Localization was successfully performed in all the NPNs. For Group A, the rate of pneumothorax immediately after localization was lower (p = 0.049) and the localization-to-surgery interval was longer (p = 0.011) than Group B. There was no significant difference in rates of hemorrhage after needle withdrawal between the two groups (p = 0.198). Hookwire ( vs medical adhesive) (β = 1.12, p = 0.018), total insertion depth (β = -0.41, p = 0.013), pleura-needle angle (β = -0.04, p = 0.025) and grade of hemorrhage after needle withdrawal (β = -0.96, p = 0.030) were independently associated with pneumothorax, while age (β = -0.94, p = 0.018), tumor size (β = 0.29, p = 0.007) and its distance from the pleural surface (β = 0.14, p = 0.004) were associated with higher grade hemorrhage after needle withdrawal.
CONCLUSION: Compared with hookwire, localization with medical adhesive excelled in lower risk of pneumothorax, a more flexible localization-to-surgery interval, and had similar rates of hemorrhage after needle withdrawal. Hookwire is an independent risk factor of pneumothorax immediately after localization.
ADVANCES IN KNOWLEDGE: This study added new clinical evidence to the efficacy of medical adhesive in pre-operative CT-guided NPN localization.
METHODS: This was a single-center non-randomized retrospective study. 102 consecutive patients with 109 NPNs were divided into Group A (medical adhesive, 66 patients, 72 nodules) and Group B (hookwire, 36 patients, 37 nodules) before VATS. Patient- and nodule-based characteristics were compared. Logistic regression was performed to identify the risk factors for complications.
RESULTS: Localization was successfully performed in all the NPNs. For Group A, the rate of pneumothorax immediately after localization was lower (p = 0.049) and the localization-to-surgery interval was longer (p = 0.011) than Group B. There was no significant difference in rates of hemorrhage after needle withdrawal between the two groups (p = 0.198). Hookwire ( vs medical adhesive) (β = 1.12, p = 0.018), total insertion depth (β = -0.41, p = 0.013), pleura-needle angle (β = -0.04, p = 0.025) and grade of hemorrhage after needle withdrawal (β = -0.96, p = 0.030) were independently associated with pneumothorax, while age (β = -0.94, p = 0.018), tumor size (β = 0.29, p = 0.007) and its distance from the pleural surface (β = 0.14, p = 0.004) were associated with higher grade hemorrhage after needle withdrawal.
CONCLUSION: Compared with hookwire, localization with medical adhesive excelled in lower risk of pneumothorax, a more flexible localization-to-surgery interval, and had similar rates of hemorrhage after needle withdrawal. Hookwire is an independent risk factor of pneumothorax immediately after localization.
ADVANCES IN KNOWLEDGE: This study added new clinical evidence to the efficacy of medical adhesive in pre-operative CT-guided NPN localization.