A Comparison between Prethoracoscopy Localization of Small Pulmonary Nodules by Means of Medical Adhesive versus Hookwire.

Purpose: To compare prethoracoscopy localization of small pulmonary nodules (SPNs) by means of medical adhesive versus hookwire.

Materials And Methods: One hundred seven patients who underwent video-assisted thoracoscopic surgery resection for SPNs were consecutively recruited in this retrospective cohort study. Patients were divided into 2 groups according to the material used for localization of the SPNs: the medical adhesive group (n = 88) and the hookwire group (n = 19). The baseline data were collected, and operation waiting time (OWT; the time gap between localization and surgery), wedge resection performing time (WRPT), pathologic result, and complications of the 2 groups were assessed.

Results: All SPNs were successfully marked. No differences in pathologic result (P = .676), wedge resection, or segmentectomy rate (P = .679) were observed. OWT was markedly longer in the medical adhesive group than in the hookwire group (P < .001), whereas WRPT was similar in the 2 groups (P = .926). There were significantly (P = .004) fewer complications in the medical adhesive group (37.42%) than in the hookwire group (15.79%). Regarding individual complications, hemorrhage occurred significantly less in the medical adhesive group than in the hookwire group (9% vs 68%; P < .001), and no differences of cough, pneumothorax, or chest pain were found between the 2 groups (all P > .05). Multivariate logistic regression analysis further validated that hookwire was independently correlated with a higher risk of complication occurrence (P = .008) and hemorrhage occurrence (P < .001) compared with medical adhesive.

Conclusions: Compared with hookwire, localization via medical adhesive can achieve a flexible time gap between localization and surgery. It also decreases the complication rate and increases convenience owing to no need for an anchor hook.