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

Area of Science:

• Thoracic Surgery
• Medical Imaging
• Pulmonary Medicine

Background:

• Preoperative computed tomography (CT)-guided localization is crucial for video-assisted thoracoscopic surgery (VATS) of pulmonary nodules (PNs).
• Two common localization methods are the anchored needle (AN) and hook-wire (HW) techniques.
• A comparative analysis is needed to evaluate their clinical performance and safety.

Purpose of the Study:

• To compare the clinical performance and safety of CT-guided AN versus HW localization for PNs.
• To assess key outcomes including localization success, complication rates, and patient pain.

Main Methods:

• A meta-analysis of seven retrospective comparative studies involving 1557 patients was conducted.
• Studies were identified through systematic searches of PubMed, Wanfang, and Cochrane Library databases.
• Data on localization success, complications (pneumothorax, hemorrhage), pain scores, and procedure times were extracted and analyzed.

Main Results:

• The AN technique showed a significantly higher successful localization rate compared to HW (P < 0.001).
• AN localization resulted in significantly lower overall complication rates (P=0.01), including pneumothorax (P=0.003) and pulmonary hemorrhage (P=0.004).
• Patients undergoing AN localization reported significantly lower pain scores (P < 0.001), with similar localization and VATS times between groups.

Conclusions:

• CT-guided AN localization is superior to the HW method for PNs, offering improved success rates and a better safety profile.
• The AN technique is associated with reduced complications and lower patient-reported pain.
• AN localization is a recommended approach for facilitating VATS resection of pulmonary nodules.