Comparison between preoperative hook-wire and liquid material localization for pulmonary nodules: a meta-analysis

Area of Science:

• Thoracic Surgery
• Medical Imaging
• Interventional Pulmonology

Background:

• Preoperative localization of pulmonary nodules (PNs) is crucial for successful video-assisted thoracic surgery (VATS).
• Computed tomography (CT)-guided liquid material localization (LML) and hook-wire localization (HWL) are common techniques, but their comparative efficacy is unclear.

Purpose of the Study:

• To conduct a meta-analysis comparing the efficacy and safety of CT-guided LML versus HWL for preoperative PN localization.

Main Methods:

• A systematic search of PubMed, Web of Science, and Wanfang databases was performed for studies published up to March 2023.
• Seven studies involving 551 patients (583 PNs) for HWL and 551 patients (612 PNs) for LML were included in the meta-analysis.

Main Results:

• Liquid material localization demonstrated a significantly higher success rate (p = 0.002) and lower complication (p = 0.007) and lung hemorrhage rates (p = 0.00001) compared to hook-wire localization.
• Localization duration, pneumothorax rates, and VATS procedure duration were comparable between the two groups.
• Postoperative hospital stay was significantly shorter in the liquid material group (p = 0.009).

Conclusions:

• CT-guided liquid material localization is a safer and more effective method for preoperative pulmonary nodule localization prior to VATS resection compared to hook-wire localization.
• Liquid material localization offers improved patient outcomes, including reduced complications and shorter hospital stays.