Preoperative computed tomography-guided localization for pulmonary nodules: comparison between hook-wire and anchored...

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Imaging

Background:

• Preoperative localization of pulmonary nodules (PNs) is crucial for successful minimally invasive resection.
• Computed tomography (CT)-guided hook-wire (HW) and anchored needle (AN) techniques are commonly used for PN localization.
• Comparative data on the safety and efficacy of HW versus AN localization are limited.

Purpose of the Study:

• To compare the safety and efficacy of CT-guided HW and AN localization for PNs.
• To evaluate outcomes such as localization success, dislodgement rates, pain, and complications.

Main Methods:

• Retrospective analysis of consecutive patients undergoing CT-guided HW or AN localization followed by video-assisted thoracoscopic surgery (VATS).
• Data collected from January 2020 to December 2021 across two institutions.
• Comparison of success rates, dislodgement, pain scores, pneumothorax, and pulmonary hemorrhage between HW and AN groups.

Main Results:

• Similar successful PN localization rates for HW (95.2%) and AN (99.1%).
• Significantly higher dislodgement rate (4.8% vs. 0.0%, p=0.029) and pain scores (p=0.001) in the HW group.
• Comparable rates of pneumothorax and pulmonary hemorrhage between the two techniques.

Conclusions:

• Anchored needle (AN) localization is a safe, well-tolerated, and feasible preoperative strategy for pulmonary nodules (PNs).
• AN may serve as a valuable replacement for hook-wire (HW) localization.
• Further research could solidify AN's role in PN management.