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Computed tomography-guided dye localization prior to uniportal thoracoscopic surgery for lung nodules: A propensity score matching analysis.
J Formos Med Assoc. 2019 Apr; 118(4):783-789.JF

Abstract

PURPOSE

Uniportal video-assisted thoracoscopic surgery (VATS) has recently been reported as an alternative to conventional VATS. However, preoperative image-guided localization is usually required for small nodules. The present study evaluated the efficacy of preoperative computed tomography-guided dye localization prior to uniportal VATS for small undetermined pulmonary nodules.

METHODS

We retrospectively reviewed 298 consecutive patients who underwent uniportal VATS to treat undetermined pulmonary nodules (diameter ≤ 1.5 cm). Propensity score matching incorporating preoperative parameters was used to reduce the selection bias in a 1:1 manner. Comprehensive data including clinical features and perioperative variables were compared to evaluate the efficacy of preoperative computed tomography (CT)-guided dye localization prior to uniportal VATS.

RESULTS

A total of 232 patients received preoperative CT-guided dye localization (localization group) and 66 did not (direct surgery group), and the propensity score matching analysis generated 55 pairs of patients in both groups. The demographics and operative outcomes, including clinical nodule size, depths of the nodule, were comparable for both groups. The complication rates were low in both groups (3.6% and 1.8%, respectively). The uniportal to multi-portal VATS conversion rate was significantly higher in the direct surgery group than in the localization group (12.7% vs 1.8%, P = 0.030). 5 cases were converted due to failure in tumor identification (7.3% vs 1.8%, P = 0.182).

CONCLUSION

Uniportal VATS is a feasible, effective, and safe procedure for the treatment of undetermined pulmonary nodules. The use of preoperative computed tomography-guided dye localization may be associated with a lower risk of conversion of uniportal VATS.

Authors+Show Affiliations

Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: chenjs@ntu.edu.tw.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

30237041

Citation

Tsai, Tung-Ming, et al. "Computed Tomography-guided Dye Localization Prior to Uniportal Thoracoscopic Surgery for Lung Nodules: a Propensity Score Matching Analysis." Journal of the Formosan Medical Association = Taiwan Yi Zhi, vol. 118, no. 4, 2019, pp. 783-789.
Tsai TM, Hung WT, Lin MW, et al. Computed tomography-guided dye localization prior to uniportal thoracoscopic surgery for lung nodules: A propensity score matching analysis. J Formos Med Assoc. 2019;118(4):783-789.
Tsai, T. M., Hung, W. T., Lin, M. W., Hsu, H. H., & Chen, J. S. (2019). Computed tomography-guided dye localization prior to uniportal thoracoscopic surgery for lung nodules: A propensity score matching analysis. Journal of the Formosan Medical Association = Taiwan Yi Zhi, 118(4), 783-789. https://doi.org/10.1016/j.jfma.2018.09.002
Tsai TM, et al. Computed Tomography-guided Dye Localization Prior to Uniportal Thoracoscopic Surgery for Lung Nodules: a Propensity Score Matching Analysis. J Formos Med Assoc. 2019;118(4):783-789. PubMed PMID: 30237041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Computed tomography-guided dye localization prior to uniportal thoracoscopic surgery for lung nodules: A propensity score matching analysis. AU - Tsai,Tung-Ming, AU - Hung,Wan-Ting, AU - Lin,Mong-Wei, AU - Hsu,Hsao-Hsun, AU - Chen,Jin-Shing, Y1 - 2018/09/18/ PY - 2018/02/07/received PY - 2018/08/23/revised PY - 2018/09/03/accepted PY - 2018/9/22/pubmed PY - 2019/8/20/medline PY - 2018/9/22/entrez KW - Preoperative computed tomography-guided localization KW - Uniportal VATS SP - 783 EP - 789 JF - Journal of the Formosan Medical Association = Taiwan yi zhi JO - J. Formos. Med. Assoc. VL - 118 IS - 4 N2 - PURPOSE: Uniportal video-assisted thoracoscopic surgery (VATS) has recently been reported as an alternative to conventional VATS. However, preoperative image-guided localization is usually required for small nodules. The present study evaluated the efficacy of preoperative computed tomography-guided dye localization prior to uniportal VATS for small undetermined pulmonary nodules. METHODS: We retrospectively reviewed 298 consecutive patients who underwent uniportal VATS to treat undetermined pulmonary nodules (diameter ≤ 1.5 cm). Propensity score matching incorporating preoperative parameters was used to reduce the selection bias in a 1:1 manner. Comprehensive data including clinical features and perioperative variables were compared to evaluate the efficacy of preoperative computed tomography (CT)-guided dye localization prior to uniportal VATS. RESULTS: A total of 232 patients received preoperative CT-guided dye localization (localization group) and 66 did not (direct surgery group), and the propensity score matching analysis generated 55 pairs of patients in both groups. The demographics and operative outcomes, including clinical nodule size, depths of the nodule, were comparable for both groups. The complication rates were low in both groups (3.6% and 1.8%, respectively). The uniportal to multi-portal VATS conversion rate was significantly higher in the direct surgery group than in the localization group (12.7% vs 1.8%, P = 0.030). 5 cases were converted due to failure in tumor identification (7.3% vs 1.8%, P = 0.182). CONCLUSION: Uniportal VATS is a feasible, effective, and safe procedure for the treatment of undetermined pulmonary nodules. The use of preoperative computed tomography-guided dye localization may be associated with a lower risk of conversion of uniportal VATS. SN - 0929-6646 UR - https://www.unboundmedicine.com/medline/citation/30237041/Computed_tomography_guided_dye_localization_prior_to_uniportal_thoracoscopic_surgery_for_lung_nodules:_A_propensity_score_matching_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-6646(18)30061-5 DB - PRIME DP - Unbound Medicine ER -