Ultrasound location of pulmonary nodules in video-assisted thoracoscopic surgery for precise sublobectomy

Yue-Long Hou, Yan-Dong Wang, Hong-Qi Guo, YuKun Zhang, YongKuan Guo, HongLi Han, Yue-Long Hou, Yan-Dong Wang, Hong-Qi Guo, YuKun Zhang, YongKuan Guo, HongLi Han

Abstract

Background: We investigated the clinical value of accurate sublobectomy of pulmonary nodules using video-assisted thoracoscopy (VATS). In June 2017 to June 2019, single lung nodule patients who accepted thoracoscopic resection were included. Palpation and intraoperative ultrasound (IU) were used to localize lung nodules, and the success rate, location time and safety compared. Performance of lung nodule ultrasound was assessed. The success rate of IU localization of pulmonary nodules with different properties was studied.

Results: A total of 33 cases with single pulmonary nodules were included in the study, and 32 cases (97%) were successfully located by IU as opposed to 16 cases (48.5%) located by palpation (P < 0.05). Clear hypoechoic ultrasound images of nodules were obtained in all 32 cases, and the diameter of pulmonary nodules on ultrasound and CT were found to have a significant correlation (R = 0.860, P = 0.000). The average positioning time of IU was lower than that of the palpation group (P < 0.05). No complications occurred during ultrasound examination. The success rate of intraoperative ultrasonic localization between the pure ground-glass opacity (p-GGO) group and the mixed-ground-glass opacity (m-GGO) group was 90%, 100% (P = 0.526).

Conclusions: In thoracoscopic surgery, IU can locate pulmonary nodules accurately, efficiently and safely, and also has a high degree of accuracy in locating different types of pulmonary nodules.

Keywords: Location; pulmonary nodule; sublobectomy; video-assisted thoracoscopic ultrasound.

© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Figures

Figure 1
Figure 1
Intraoperative ultrasound localization of pulmonary nodules.
Figure 2
Figure 2
(a) CT scan and (b) ultrasound which confirmed the presence of pure ground‐glass nodules.
Figure 3
Figure 3
(a) CT scan and (b) ultrasound manifestations of pulmonary nodules.
Figure 4
Figure 4
Correlation coefficient between pulmonary nodule diameter on CT scan and ultrasound, R = 0.860, P < 0.05.
Figure 5
Figure 5
Pulmonary nodule localization time. Palpation represents the palpation group. UI represents the intraoperative ultrasound group. P < 0.05.
Figure 6
Figure 6
Intraoperative ultrasonography of pulmonary embolism. (a) Doppler image. The visible filling defect is a thrombus. (b) A clot can be seen in the blood vessel.

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