LAUSR

Screening for ear ly-stage lung cancer with lowdose computed tomography (CT) reduces associated mortality while increasing the detection rate of small pulmonary nodules and ground-glass nodules (GGNs) (1). Currently, the most common method for diagnosing and resectioning small pulmonary nodules and GGNs is videoassisted thoracoscopic surgery (VATS). For pure GGNs, mixed GGNs, and small nodules not adjacent to the pleura, preoperative localization is usually required to ensure that these nodules can be found during surgery. Otherwise, failure of surgical resection, extended resection, or conversion to thoracotomy may ensue. Pulmonary nodules can be localized using various methods, including electromagnetic navigation bronchoscopy (2), ultrasound-guided approaches (3), and CT-guided approaches (4). The most common method is preoperative CT-guided localization using different marker materials. However, CT-guided localization technology has a unique characteristic that the patient must be positioned in the CT room before surgery and then transferred to the operating room for VATS. Some risks, such as pneumothorax, pulmonary hemorrhage, and wire shedding, cannot be ignored during transport. Although hybrid operating rooms equipped with cone-beam CT can achieve one-stop localization of small pulmonary nodules, there are site constraints and high assembly costs. Here, we report a case in which planning the localization path was combined with preoperative 3-dimensional (3D) reconstruction of the lung, with one-stop pulmonary nodule localization and VATS wedge resection being completed using the mobile 3D C-arm system. This provided a preliminary experience in exploring the shortening of the localization time of pulmonary nodules, improving the success rate of localization, and reducing complications.