Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study

Abstract

Background Preoperative computed tomography (CT)-guided coil localization (CL) is commonly used to facilitate video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) is localized, the trans-scapular CL (TSCL) is commonly performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs. Materials and methods From January 2014 to September 2020, a total of 152 patients with PNs underwent CT-guided CL prior to VATS-guided WR. Of these patients, 14 had SBPNs and underwent the TSCL procedure. Results A total of 14 SBPNs were localized in the 14 patients. The mean diameter of the 14 SBPNs was 7.4\u2009±\u20092.4\u2009mm. The technical success rate of the scapula puncture was 100%. No complications occurred near the scapula. The technical success rate of CL was 92.9%. One coil dropped off when performing the VATS procedure. The mean duration of the TSCL was 14.2\u2009±\u20092.7\u2009min. Two patients (14.3%) developed asymptomatic pneumothorax after TSCL. The technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean duration of the VATS was 90.0\u2009±\u200942.4\u2009min and the mean blood loss was 62.9\u2009±\u200937.2\u2009ml. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma ( n \u2009=\u20094), adenocarcinoma in situ ( n \u2009=\u20099), and benign disease ( n \u2009=\u20091). Conclusions Preoperative CT-guided TSCL is a safe and simple procedure that can facilitate high success rates of VATS-guided WR of SBPNs.