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Background  This retrospectively study was conducted to assess the efficiency and safety of computed tomography (CT)‐guided hook wire localization of pulmonary ground‐glass nodules (GGNs) prior to video‐assisted thoracoscopic surgery (VATS).    Methods  From 2015 to 2018, a total of 86 patients with 86 pulmonary GGNs underwent preoperative CT‐guided hook wire localization before VATS. The technical details and clinicopathological findings were analyzed.    Results  All 86 pulmonary GGNs (25 pure GGNs and 61 part‐solid GGNs) were successfully located and resected. The mean diameter of the GGNs was 1.4 ± 0.4 cm (range 0.6–2.2) and the mean lesion distance to the pleural surface was 7.3 ± 4.3 mm (range 2–19). Complications of hook wire marking included asymptomatic minor pneumothorax in 21 patients (24%) and focal pulmonary hemorrhage in 18 (21%). The median hook wire localization time was 19.1 minutes (range 10–30) and the median VATS time was 49 minutes (range 28–89). Pathology revealed 72 precancerous lesions or primary lung adenocarcinomas, 5 metastatic tumors, and 9 benign lesions.    Conclusions  Preoperative localization of small pulmonary GGNs using CT‐guided hook wire was efficient and safe prior to VATS resection.

Computed tomography‐guided hook wire localization facilitates video‐assisted thoracoscopic surgery of pulmonary ground‐glass nodules