Retrospective comparative study of CT-guided needle localization versus medical glue localization for preoperative management of pulmonary nodules

Abstract

Background: Video-assisted thoracoscopic surgery (VATS) is the preferred treatment for pulmonary nodules, making preoperative localization crucial. Aim: This study compared the effectiveness and complications of two computed tomography (CT)-guided localization methods for pulmonary nodules: localization needle and medical glue. Methods: This retrospective study included 86 patients with pulmonary nodules undergoing preoperative localization at the First Affiliated Hospital of Guangxi Medical University (July 2023 - April 2024). The patients were divided into two groups: the localization needle group (n=64) and the medical glue group (n=22). Clinical data, including baseline characteristics, localization-related data, complications, and surgical outcomes, were collected and analyzed, and subgroup analyses were done to identify risk factors for pneumothorax and pulmonary hemorrhage. Results: Both methods achieved a 100% localization success rate, with all nodules successfully resected. The needle group had longer localization time (17.19 vs. 15.36 min, p<0.05) and higher pneumothorax incidence (23.4% vs. 4.5%, p<0.05). The needle group also had a lower cough incidence (1.6% vs. 22.7%, p<0.05) but higher pain scores (2.89 vs. 2.36, p<0.05). No significant differences were observed in intrapulmonary hemorrhage, operative time, surgical approach, or postoperative pathology (p>0.05) between the two groups. However, subgroup analysis revealed significant differences in puncture times, localization methods, nodule size, lung history, and puncture depth related to pneumothorax and hemorrhage (p<0.05). Conclusion: Both CT-guided localization methods are safe and effective for VATS. The number of punctures is a key risk factor for complications such as pneumothorax and intrapulmonary hemorrhage, emphasizing the importance of careful planning and technique during localization. Relevance for patients: Identifying the most effective localization methods for pulmonary nodules ensures a higher success rate in surgeries, with fewer complications, ultimately leading to better patient outcomes and faster recovery. Proper preoperative localization helps reduce the risk of adverse events like pneumothorax, ensuring safer procedures and improved overall care for patients.

Keywords

CT-guided localization / Pulmonary nodules / Needle localization / Medical glue / Video-assisted thoracoscopic surgery

Funding

This work was supported in part by Self-financed Scientific Research of Guangxi Zhuang Autonomous Region Health Commission (Z20211032), Guangxi Medical and Health Appropriate Technology Development and Popularization Application Project (S2022070), the Joint Project on Regional High-Incidence Diseases Research of Guangxi Natural Science Foundation (2024GXNSFBA010032), the Youth Science Foundation of Guangxi Medical University (GXMUYSF202420), the National Key Clinical Specialty Construction Project, Guangxi Medical and Health Key Discipline Construction Project and Guangxi Key Clinical Specialty Construction Project.

Conflict of interest

There are no conflicts of interest.

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