Wang Si-Jia, Gao Xing-Xing, Hui Hui, Li Na, Zhou Yun, Yin Hai-Tao
Department of Radiotherapy, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China.
Department of Radiotherapy, First Clinical School of Xuzhou Medical University, Xuzhou, China.
Wideochir Inne Tech Maloinwazyjne. 2023 Sep;18(3):401-409. doi: 10.5114/wiitm.2023.130330. Epub 2023 Aug 4.
Computed tomography (CT)-guided liquid material (LM) and hook-wire (HW) are usually localized for pulmonary nodules (PNs) before video-assisted thoracic surgery (VATS) resection, but the relative advantages of these 2 techniques remain uncertain.
This meta-analysis was conceived to juxtapose the efficacy and safety of HW localization (HWL) and LM localization (LML), both guided by CT, for the preoperative localization of PNs.
The PubMed, Web of Science, and Wanfang databases were searched to identify relevant studies published as of March 2023, after which pooled analyses of study outcomes were conducted.
A total of 7 studies were included in this meta-analysis from 142 relevant studies. These 7 studies included 551 patients (583 PNs) with CT-guided HWL and 551 patients (612 PNs) with LML. The successful localization rate was significantly higher in the LM group (LMG) than in the HW group (HWG) (p = 0.002). The LMG also exhibited significantly lower pooled total complication and lung haemorrhage rates than the HWG (p = 0.007 and 0.00001, respectively). Pooled localization duration, pneumothorax rates, and VATS procedure duration were comparable in both groups (p = 0.45, 0.15, and 0.74, respectively). Furthermore, the pooled postoperative hospital stay was significantly shorter in the LMG than in the HWG (p = 0.009). Significant heterogeneity was detected in the endpoints of localization duration and pneumothorax rate (I = 93% and 66%, respectively).
CT-guided LML is safer and more successful than HWL for patients with PNs before VATS resection.
在电视辅助胸腔镜手术（VATS）切除术前，计算机断层扫描（CT）引导下的液体材料（LM）和钩丝（HW）通常用于肺结节（PN）的定位，但这两种技术的相对优势仍不明确。
本荟萃分析旨在比较CT引导下HW定位（HWL）和LM定位（LML）在PN术前定位中的有效性和安全性。
检索了PubMed、Web of Science和万方数据库，以识别截至2023年3月发表的相关研究，之后对研究结果进行汇总分析。
本荟萃分析共纳入了142项相关研究中的7项研究。这7项研究包括551例接受CT引导下HWL的患者（583个PN）和551例接受LML的患者（612个PN）。LM组（LMG）的成功定位率显著高于HW组（HWG）（p = 0.002）。LMG的汇总总并发症和肺出血率也显著低于HWG（分别为p = 0.007和0.00001）。两组的汇总定位持续时间、气胸发生率和VATS手术持续时间相当（分别为p = 0.45、0.15和0.74）。此外，LMG的汇总术后住院时间显著短于HWG（p = 0.009）。在定位持续时间和气胸发生率的终点中检测到显著异质性（分别为I = 93%和66%）。
对于VATS切除术前的PN患者，CT引导下的LML比HWL更安全且更成功。
