Computed tomography-guided simultaneous coil localization as a bridge to one-stage surgery for multiple lung nodules: a retrospective study

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been widely used for diagnostic wedge resection of lung nodules. When VATS is performed for multiple lung nodules, preoperative localization for each target nodule is required. In this study, we evaluated the clinical effectiveness of computed tomography (CT)-guided simultaneous coil localization in one-stage VATS wedge resection for multiple lung nodules. METHODS: Between November 2015 to March 2018, 19 patients with multiple target nodules underwent CT-guided simultaneous coil localization and one-stage VATS resection at our center. Data on the technical success of simultaneous localization and wedge resection, complications, and pathological results were collected. RESULTS: A total of 43 nodules were localized. The localization was successfully achieved in 42 of 43 nodules (97.7%). The technique of simultaneous localization was successfully achieved in 18 of 19 patients (94.7%). Fifteen patients underwent unilateral lung localization and four patients underwent bilateral lung localization. Three patients (15.8%) experienced asymptomatic pneumothorax after localization. All patients successfully underwent one-stage wedge resection for all target nodules. The mean duration of one-stage VATS procedure was 171.8 ± 84.0 min. The mean volume of blood loss was 94.2 ± 58.0 mL. Three patients experienced pleural effusion after VATS. During a follow-up of 6–31 months (median 18 months), no patient developed new lung nodules or distant metastasis. CONCLUSIONS: Preoperative simultaneous coil implantation is a safe and simple method for localization of multiple lung nodules. Simultaneous coil localization could effectively guide a one-stage VATS diagnostic wedge resection procedure.