Department of Thoracic and Cardiovascular Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, 215000, China.
Department of Thoracic Surgery, Xuzhou Central Hospital, Clinical School of Xuzhou Medical University, Xuzhou, China, 221009.
World J Surg Oncol. 2024 Nov 30;22(1):320. doi: 10.1186/s12957-024-03593-1.
Precise preoperative localization is crucial for improving the success rate and reducing the duration of thoracoscopic surgeries. This study aimed to evaluate the efficacy, safety, and patient perception of the four-hook localization needle compared to the traditional double-hook localization needle in the localization of pulmonary nodules.
We conducted a retrospective analysis of 207 patients who underwent video-assisted thoracoscopic surgery (VATS). Seventy-six patients used a four-hook localization needle preoperatively, while 121 patients used the traditional double-hook needle. Propensity score matching was employed to balance the baseline characteristics of the two groups and minimize confounding bias. We compared the surgery success rate, surgical field success rate, complication rate, and post-localization respiratory pain score between the two groups.
Both localization methods achieved a 100% success rate. The four-hook needle had a statistically significant shorter localization time (20.00 min vs. 21.00 min, P = 0.046) and a lower preoperative displacement rate (5.81% vs. 17.36%, P = 0.014) compared to the double-hook needle. Both before and after propensity score matching, the postoperative respiratory pain score was significantly lower in the four-hook group compared to the double-hook group (P < 0.001). After balancing baseline characteristics, univariate (P = 0.036) and multivariate (P = 0.039) logistic regression analyses indicated that the four-hook group had a significantly lower risk of localization complications compared to the double-hook group.
The four-hook localization needle outperforms the traditional double-hook needle due to its shorter localization time, lower post-localization respiratory pain score, and reduced displacement rate, making it a simpler and safer option. Furthermore, the four-hook needle effectively reduces the risk of complications, presenting a promising method for preoperative localization of pulmonary nodules.
精确的术前定位对于提高胸腔镜手术的成功率和缩短手术时间至关重要。本研究旨在评估四钩定位针与传统双钩定位针在肺结节定位中的疗效、安全性和患者感知。
我们回顾性分析了 207 例接受电视辅助胸腔镜手术（VATS）的患者。76 例患者术前使用四钩定位针，121 例患者使用传统双钩针。采用倾向评分匹配法平衡两组的基线特征，最大限度地减少混杂偏倚。比较两组的手术成功率、手术野成功率、并发症发生率和定位后呼吸痛评分。
两种定位方法的成功率均为 100%。四钩针的定位时间明显短于双钩针（20.00 分钟比 21.00 分钟，P=0.046），术前移位率也明显低于双钩针（5.81%比 17.36%，P=0.014）。在倾向评分匹配前后，四钩组的术后呼吸痛评分均明显低于双钩组（P<0.001）。单因素（P=0.036）和多因素（P=0.039）逻辑回归分析表明，四钩组的定位并发症风险明显低于双钩组。
四钩定位针由于定位时间更短、定位后呼吸痛评分更低、移位率更低，因此比传统双钩针更具优势，是一种更简单、更安全的选择。此外，四钩针可有效降低并发症风险，为肺结节的术前定位提供了一种有前途的方法。
