CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Shinichiro Miyoshi, Susumu Kanazawa

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives: To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. Methods: We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Results: Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Conclusion: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Key Points: • Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. • Complications are usually minor and asymptomatic. • A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

Original languageEnglish
Pages (from-to)114-121
Number of pages8
JournalEuropean Radiology
Volume26
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Fluoroscopy
Pneumothorax
Odds Ratio
Tomography
Safety
Lung
Video-Assisted Thoracic Surgery
Vital Capacity
Multivariate Analysis

Keywords

  • Complications
  • Interventional radiology
  • Lung
  • Pneumothorax
  • Video-assisted thoracoscopic surgery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax",
abstract = "Objectives: To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. Methods: We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Results: Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Conclusion: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Key Points: • Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. • Complications are usually minor and asymptomatic. • A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.",
keywords = "Complications, Interventional radiology, Lung, Pneumothorax, Video-assisted thoracoscopic surgery",
author = "Toshihiro Iguchi and Takao Hiraki and Hideo Gobara and Hiroyasu Fujiwara and Yusuke Matsui and Shinichiro Miyoshi and Susumu Kanazawa",
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language = "English",
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T1 - CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions

T2 - evaluation of safety and identification of risk factors for pneumothorax

AU - Iguchi, Toshihiro

AU - Hiraki, Takao

AU - Gobara, Hideo

AU - Fujiwara, Hiroyasu

AU - Matsui, Yusuke

AU - Miyoshi, Shinichiro

AU - Kanazawa, Susumu

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objectives: To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. Methods: We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Results: Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Conclusion: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Key Points: • Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. • Complications are usually minor and asymptomatic. • A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

AB - Objectives: To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. Methods: We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Results: Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Conclusion: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Key Points: • Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. • Complications are usually minor and asymptomatic. • A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

KW - Complications

KW - Interventional radiology

KW - Lung

KW - Pneumothorax

KW - Video-assisted thoracoscopic surgery

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