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


METHODS
This 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.


RESULTS
The 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).


CONCLUSIONS
There 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.
['Park|Chul Hwan|CH|', 'Lee|Sang Min|SM|', 'Lee|Ji Won|JW|', 'Hwang|Sung Ho|SH|', 'Kwon|Woocheol|W|', 'Han|Kyunghwa|K|', 'Hur|Jin|J|', '|||']
D000368:Aged D000970:Antineoplastic Agents D003287:Contrast Media D004998:Ethiodized Oil D005260:Female D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D011183:Postoperative Complications D011446:Prospective Studies D003074:Solitary Pulmonary Nodule D020775:Thoracic Surgery, Video-Assisted D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
hook-wire localization lipiodol ground-glass opacity video-assisted thoracic surgery