CT-Guided Anchored Needle Versus Hook-Wire Localization for Pulmonary Nodules: A Meta-Analysis

Preoperative computed tomography (CT)-guided localization is widely used to facilitate the surgical resection of pulmonary nodules (PNs) through video-assisted thoracoscopic surgery (VATS). This meta-analysis aims to compare the clinical performance and safety profile of 2 commonly used localization techniques: the anchored needle (AN) and the hook-wire (HW) method. A systematic search was conducted using the PubMed, Wanfang, and Cochrane Library databases to identify relevant comparative studies. Key outcome measures were extracted and analyzed using Stata v12.0 and RevMan v5.3. Seven retrospective studies conducted in China met the inclusion criteria, encompassing a total of 1557 patients. Among these, 889 patients with 961 PNs underwent CT-guided AN localization, whereas 668 patients with 697 PNs received HW localization. Compared with HW, AN localization demonstrated a significantly higher rate of successful localization ( P <0.001), lower rates of overall complications ( P =0.01), pneumothorax ( P =0.003), and pulmonary hemorrhage ( P =0.004). Patients in the AN group also reported significantly lower pain scores ( P <0.001). Two groups exhibited similar localization ( P =0.48) and VATS ( P =0.93) time. Notable heterogeneity was observed in localization time, complication rate, VATS time, and pain score ( I ²=91%, 73%, 94%, and 94%, respectively). No evidence of publication bias was detected across the analyzed outcomes. CT-guided AN localization seems to offer higher successful localization rate and a lower complication rate compared with HW localization for patients undergoing surgical management of PNs.