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Hook-wire Localization Versus Lipiodol Localization for Patients With Pulmonary Lesions Having Ground-Glass Opacity

Authors
 Chul Hwan Park  ;  Sang Min Lee  ;  Ji Won Lee  ;  Sung Ho Hwang  ;  Woocheol Kwon  ;  Kyunghwa Han  ;  Jin Hur  ;  LOGIS investigators 
Citation
 JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, Vol.159(4) : 1571-1579.e2, 2020-04 
Journal Title
 JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 
ISSN
 0022-5223 
Issue Date
2020-04
Keywords
ground-glass opacity ; hook-wire ; lipiodol ; localization ; video-assisted thoracic surgery
Abstract
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.
Full Text
https://www.sciencedirect.com/science/article/pii/S0022522319318999
DOI
10.1016/j.jtcvs.2019.08.100
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
Lee, Kye Ho(이계호) ORCID logo https://orcid.org/0000-0001-5568-1833
Im, Dong Jin(임동진) ORCID logo https://orcid.org/0000-0001-8139-5646
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/22282913/176219
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