Comparison of different localization needles and postures in localization of pulmonary nodules

Background: With advancements in imaging testing and surgical procedures, an increasing number of nodules with smaller diameters and deeper locations have been deemed suitable for surgical intervention. The preoperative localization of these nodules has become essential. In this retrospective single-center study, we aimed to compare the effectiveness and patient comfort associated with the use of a four-hook needle versus a hook-wire needle for preoperative localization. Additionally, we sought to evaluate the impact of different patient postures on localization effectiveness.

Methods: We retrospectively analyzed the data of 692 patients following preoperative CT-guided localization. The patients were categorized into different groups based on the type of localization needles used and their respective postures during localization.

Results: There was no statistical difference in total complications between the four-hook needle group and the hook-wire needle group (P > 0.05). The chest pain score in the four-hook needle group was lower than the hook-wire needle group (P = 0.001). The incidence of decoupling in the four-hook needle group was significantly lower than the hook-wire needle group (P < 0.05). The four-hook needle group had better performance in terms of localization operation time, operation time, intraoperative bleeding and first-day drainage (P < 0.05). Compared with the supine and lateral groups, the prone posture group had better performance in total complications and localization operation time, and worse performance in decoupling and chest pain (P < 0.05).

Conclusions: The four-hook needle has better effectiveness on localization and comfort in patient than the hook-wire needle, which is worthy of clinical promotion and application. The patient's different postures during localization procedure may affect the localization results.