Clinical Usefulness of Preoperative Computed Tomography-Guided Needle Localization of Small Pulmonary Nodules for Video-Assisted Thoracic Surgery

Objective: To evaluate the clinical usefulness of preoperative computed tomography (CT)-guided needle localization of small pulmonary nodules for video-assisted thoracic surgery (VATS). Materials and Methods: Between October 2018 and June 2021, 32 consecutive small pulmonary nodules were treated with preoperative CTguided needle localization of less than 2 cm pulmonary nodules for VATS. All basic characteristic and Procedural success, technical success, and complication rates were evaluated from the medical record. Results: The procedures were blue-dye needle localization by isosulfan blue (94%), and hook-wire needle localization (6%). The median size of the tumor was 9 mm (range 2 to 17 mm). The initial procedural success rate of the CT-guided needle localization procedure was 100%. The technical success rate was 90.6%. Approximately 73% of the resected lung nodules were pathologically proven malignancies. Minor complications, such as minimal pneumothorax (34%) and minimal parenchymal hemorrhage (13%), occurred at the needle access site. Conclusion: Preoperative CT-guided needle localization in VATS for small pulmonary nodules was feasible and safe. Keywords: Thoracic surgery; Video-assisted; Multiple pulmonary nodules; Tomography; X-Ray computed