Comparison of hook wire and microcoil preoperative localisation in subsolid pulmonary nodules: a retrospective...

Subsolid nodules are increasingly detected during physical examinations with computed tomography (CT) scan and video-assisted thoracoscopic surgery (VATS) is the standard treatment. This study compared the effectiveness of preoperative localisation of subsolid pulmonary nodules using a hook-wire and a microcoil under CT guidance prior to VATS.

Patients with solitary subsolid pulmonary nodules (n = 342) underwent percutaneous puncture localisation guided by CT before VATS. Overall, 107 were localised using a hook wire (hook-wire group), and 235 patients were localised using a microcoil (microcoil group). Localisation-related indicators, complications associated with localisation surgery, and VATS-related indicators were compared between the two groups.

The success rate of localisation was not different between the two groups [hook-wire group: 92.52% (99/107) vs microcoil group: 96.17% (226/235), P = 0.150). The localisation time and time window between localisation and surgery were shorter in the hook-wire group than in the microcoil group (P < 0.001). However, the overall incidence of complications related to localisation surgery was greater in the hook-wire group than in the microcoil group [48.60% (52/107) vs. 31.49% (74/235), P = 0.002]. Both groups mainly underwent pulmonary lobectomy as the primary surgical procedure, with no statistically significant difference in the surgical approach between the groups (P = 0.084). Surgical time for patients who underwent pulmonary lobectomy was shorter in the microcoil group than in the hook-wire group (P = 0.023).

The effectiveness of preoperative localisation of subsolid pulmonary nodules using hook-wire and microcoils under CT guidance prior to VATS is comparable. The microcoil technique has a longer localisation time but a lower overall complication rate and shorter surgical time for pulmonary lobectomy.