Intraoperative titanium clip localization versus preoperative medical glue localization for pulmonary nodules: a prospective cohort study
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Updated: Oct 31, 2026
CT-guided Preoperative Localization of Pulmonary Nodules Using a Glucose Test and Tissue Adhesive
Published on: January 30, 2026
Jiangyu Wu1, Huiling Guo2, Wenxin Tian3
1Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
Background:
Preoperative CT-guided percutaneous localization of pulmonary nodules is widely used in clinical practice but is often associated with localization-related complications. Intraoperative titanium clip localization may provide a safer localization strategy. This study aimed to compare the effectiveness and safety of these two approaches.
Methods:
This single-center prospective cohort study included 189 patients who underwent pulmonary nodule resection after localization between October 2023 and November 2025. Patients were divided into an intraoperative titanium clip localization group (n = 123) and a preoperative medical glue localization group (n = 66) based on the localization method. Localization success rate, localization-related complications, and perioperative outcomes were analyzed.
Results:
A total of 252 pulmonary nodules were localized. The intraoperative group demonstrated a significantly higher localization success rate than the preoperative group (99.4% vs. 89.0%; OR, 18.07; 95% CI, 2.18-149.84; P = 0.007), along with a lower incidence of localization-related complications (0% vs. 30.3%; OR, 0.004). However, the duration of general anesthesia was longer in the intraoperative group (196.34 ± 54.46 vs. 162.76 ± 57.19 min; P = 0.001). There were no significant differences in postoperative drainage volume, postoperative complication rates, or length of hospital stay between the two groups.
Conclusions:
Intraoperative titanium clip localization demonstrated a higher localization success rate and a lower incidence of localization-related complications. It may have potential value for simultaneous localization of multiple pulmonary nodules. However, this approach was associated with a longer duration of general anesthesia.
