Preoperative CT-guided lung nodule localization: Comparison of Chiba needle and Trocar needle

To compare the relative safety and efficacy of the Chiba needle and the Trocar needle in CT-guided microcoil localization of pulmonary nodules.

A retrospective study was conducted on 118 patients who underwent CT-guided microcoil localization and subsequent video-assisted thoracoscopic surgery (VATS) resection from September to November 2023. Patients were divided into the Chiba needle group (n = 75) and the Trocar needle group (n = 43). Characteristics of patients, lesions, procedures, and surgeries were statistically analyzed. Univariate and multivariate logistic regression analyses were used to determine potential risk factors for technical failure and complications.

The success rate of localization was 97.3 % for the Chiba needle group and 100 % for the Trocar needle group, with no significant difference (p = 0.533). Complications included pneumothorax in 16 % of the Chiba group and 18.6 % of the Trocar group (p = 0.914), and parenchymal hemorrhage in 25.3 % and 41.9 % respectively (p = 0.098). There were no significant differences in puncture depth, procedure duration, or interval between procedure and surgery. Multivariate logistic regression analyses identified longer puncture depth as a risk factor both for pneumothorax (p = 0.027) and parenchymal hemorrhage (p = 0.006), while the Trocar needle was identified as a risk factor for parenchymal hemorrhage (p = 0.035).

This study found no significant difference in the effectiveness of Chiba and Trocar needles for preoperative CT-guided lung nodule localization. Both needles showed high success rates and comparable pneumothorax profiles. However, the Trocar needle was found associated with a higher incidence of parenchymal hemorrhage.