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Comparative Effectiveness and Safety of Preoperative Lung Localization for Pulmonary Nodules: A Systematic Review and Meta-analysis

Authors
 Chul Hwan Park  ;  Kyunghwa Han  ;  Jin Hur  ;  Sang Min Lee  ;  Ji Won Lee  ;  Sung Ho Hwang  ;  Jae Seung Seo  ;  Kye Ho Lee  ;  Woocheol Kwon  ;  Tae Hoon Kim  ;  Byoung Wook Choi 
Citation
 CHEST, Vol.151(2) : 316-328, 2017 
Journal Title
CHEST
ISSN
 0012-3692 
Issue Date
2017
MeSH
Contrast Media ; Ethiodized Oil ; Humans ; Pneumothorax/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Hemorrhage/epidemiology ; Solitary Pulmonary Nodule/diagnostic imaging ; Solitary Pulmonary Nodule/pathology ; Solitary Pulmonary Nodule/surgery* ; Surgery, Computer-Assisted ; Surgical Instruments ; Thoracic Surgery, Video-Assisted/methods* ; Tomography, X-Ray Computed
Keywords
hook-wire ; lipiodol ; localization ; lung nodule ; microcoil
Abstract
BACKGROUND: An optimal method of preoperative localization for pulmonary nodules has yet to be established. This systematic review and meta-analysis aimed to compare the success and complication rates associated with three pulmonary nodule localization methods for video-assisted thoracoscopic surgery (VATS): hook-wire localization, microcoil localization, and lipiodol localization.

METHODS: We searched the PubMed, MEDLINE, and EMBASE databases for prospective or retrospective English language studies of VATS localization in adult patients. A noncomparative, random effects model-based meta-analysis was performed to obtain pooled success and complication rates for the three localization methods.

RESULTS: A total of 46 clinical studies were enrolled, including 30, 9, and 7 studies of hook-wire, microcoil, and lipiodol localization, respectively. The successful targeting rates for hook-wire, microcoil, and lipiodol localization were 0.98 (95% CI, 0.97-0.99), 0.98 (95% CI, 0.96-0.99), and 0.99 (95% CI, 0.98-1.00), respectively, with corresponding successful operative field targeting rates of 0.94 (95% CI, 0.91-0.96), 0.97 (95% CI, 0.95-0.98), and 0.99 (95% CI, 0.98-1.00), respectively. In addition, the successful VATS rates with hook-wire, microcoil, and lipiodol localization were 0.96 (95% CI, 0.94-0.97), 0.97 (95% CI, 0.94-0.99), and 0.99 (95% CI, 0.98-1.00), respectively. Regarding complications, hook-wire, microcoil, and lipiodol localization were associated with pneumothorax rates of 0.35 (95% CI, 0.28-0.43), 0.16 (95% CI, 0.07-0.34), and 0.31 (95% CI, 0.20-0.46), respectively and hemorrhage rates of 0.16 (95% CI, 0.11-0.23), 0.06 (95% CI, 0.03-0.11), and 0.12 (95% CI, 0.05-0.23), respectively.

CONCLUSIONS: All three localization methods yielded similarly highly successful targeting rates. However, hook-wire localization had a relatively lower successful operative field targeting rate because of dislodgement or migration. Lipiodol localization had the highest overall success rate, and microcoil localization yielded the lowest complication rates.
Full Text
http://www.sciencedirect.com/science/article/pii/S0012369216593106
DOI
10.1016/j.chest.2016.09.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154419
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