Computed tomography-guided Sens-cure needle localization for scapular-blocked lung nodules

Introduction
The use of preoperative computed tomography (CT) to guide the wedge resection (WR) of lung nodules (LNs) in video-assisted thoracoscopic surgery (VATS) is widely accepted. However, some LNs may be blocked by the scapula and a trans-scapular approach should be used when performing the localization procedures.

Aim
To investigate the feasibility, safety, and clinical effectiveness of preoperative CT-guided Sens-cure needle (SCN) localization for scapula-blocked LNs (SBLNs).

Material and methods
One hundred and eighty patients with LNs who had undergone CT-guided SCN localization before VATS were enrolled in this single-center retrospective study from January 2018 to December 2021. Ten of these patients (5.6%) had SBLNs and underwent localization using the trans-scapular approach. The technical success of localization, together with complications and VATS, was assessed.

Results
Data on the 10 patients with 10 SBLNs were analyzed. Scapular puncture was successful in all patients (100%) with no incidence of complications near the scapula. SCN localization was also successful in 100% of patients. The average duration of SCN localization was 12.5 ±4.0 min, with 1 (10%) patient experiencing pneumothorax after localization. The WR success rate was also 100%. Three patients underwent additional lobectomy due to invasive adenocarcinoma. The VATS procedure lasted on average for 97.0 ±56.0 min with an average blood loss of 44.0 ±35.0 ml.

Conclusions
Preoperative CT-guided SCN localization using the trans-scapular approach is safe, effective, and highly successful for VATS-guided WR of SBLNs.