Abstract
BackgroundPrecise preoperative localization is of great importance to improve the success rate and reduce the operation time of VATS surgery. This study aimed to assess the efficacy, safety, patient perception between CT-guided indocyanine green (ICG) preoperative localization of lung nodule and hook-wire localization.Methods65 patients with 85 clinically suspicious pulmonary nodules underwent ICG preoperative localization in this study, and 92 patients with 95 nodules localized by conventional hook-wire served as controls. Both hook-wire localization and ICG injection were performed under CT guidance. Successful targeting rate, success rate in the operative field, incidence rate of complications and respiratory pain score were recorded and compared.ResultsThe successful targeting rate for both groups is 100%, however, due to hook-wire dislodgement, the success rate in the VATS operation field of the hook-wire group (95.6%) is lower than that of the ICG group (100%), with no significant difference(p=0.056). The overall complication rate of the hook-wire group (37.0%) is significantly higher than the ICG group (35.4%) (p=0.038). The mean respiratory pain score of the hook-wire group is 3.70 ± 1.25, which is significantly higher than that of the ICG group (2.85 ± 1.05) (p<0.001).ConclusionsICG composed with contrast mixture are superior to the conventional hook-wire preoperative lung nodule localization procedure, with a lower complication rate, lower pain score, and relatively higher success rate. ICG is a promising alternative method for pulmonary nodule preoperative localization.
Highlights
Lung cancer is the most common form of cancer and the leading cause of cancer death worldwide [1]
The indocyanine green (ICG) was taken into practice in our institution in October 2020, after that until February 2021, 65 consecutive patients with 85 clinically suspicious pulmonary nodules who underwent ICG guided localization were included in this study
Identifying non-palpable and non-visible pulmonary nodule during video-assisted thoracoscopic surgery (VATS) surgery is challenging, precise preoperative localization is of great importance to improve the success rate and reduce operation time of VATS surgery
Summary
Lung cancer is the most common form of cancer and the leading cause of cancer death worldwide [1]. Several preoperative pulmonary nodule localization methods have been applied to improve the intraoperative nodule visibility [6]. The most commonly adopted marking technique is perhaps the preoperative CT-guided hook-wire localization [6]. The documented successful intraoperative targeting rate can be up to 94%-100% [7,8,9], complications such as pneumothorax, hemorrhage and wire dislodgement are commonly seen, while air embolism and other fetal events are rare complications. Precise preoperative localization is of great importance to improve the success rate and reduce the operation time of VATS surgery. This study aimed to assess the efficacy, safety, patient perception between CT-guided indocyanine green (ICG) preoperative localization of lung nodule and hook-wire localization
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