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Updated: Jan 11, 2026
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
Advantages of electromagnetic navigation bronchoscopy in localizing pulmonary nodules challenging to traditional
Kai Fu1,2, Shu Pan1,2, Zi-Qing Shen1,2
1Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, China.
Background:
Electromagnetic navigation bronchoscopy (ENB)-guided localization is expected to demonstrate higher success rates and a superior safety profile compared to computed tomography (CT)-guided hook-wire localization. This study aimed to compare the efficacy and safety of CT-guided hook-wire localization versus ENB-guided localization for preoperative marking of pulmonary nodules in areas where hook-wire placement is technically challenging prior to video-assisted thoracoscopic surgery (VATS).
Methods:
We conducted a retrospective analysis of 145 patients with solitary small pulmonary nodules who underwent either CT-guided (n=103) or ENB-guided (n=42) localization at The First Affiliated Hospital of Soochow University between September 2022 and September 2024. The study compared procedural characteristics including localization success rates, operation times, and complication rates between the two approaches.
Results:
The CT-guided group demonstrated significantly shorter mean localization time (P<0.001) and general anesthesia duration (P<0.001) compared to the ENB group. However, CT-guided procedures required prolonged needle-carrying time (24.8±4.6 minutes, P<0.001). ENB showed superior success rates (100% vs. 81.6%, P=0.003) with no major complications (0/42 vs. 42/103, P<0.001). Postoperative complication rates related to VATS were similar between groups (ENB: 9.5% vs. CT: 4.9%, P=0.50).
Conclusions:
For pulmonary nodules in locations where hook-wire placement is technically challenging, both ENB-guided and CT-guided localization techniques can effectively identify the targets. The ENB approach demonstrates superior success rates, fewer complications and lower adverse event rates, suggesting that for such challenging nodules, ENB represents a promising, safe, and feasible localization method.
