Wu Yonghui, Xu Jiannan, Zhang Kai, Huang Yuanheng, Zhang Jian, Chen Huiguo
Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, 510630, People's Republic of China.
J Cardiothorac Surg. 2025 Mar 6;20(1):146. doi: 10.1186/s13019-025-03371-4.
The aim of this study was to evaluate the efficacy of the 4-hook needle localization for pulmonary ground glass nodules (GGNs).
From November 1, 2021, to May 31, 2024, 194 patients were diagnosed with one or more GGNs by computed tomography (CT) scan and underwent preoperative CT-guided 4-hook needle localization followed by video-assisted thoracoscope surgery (VATS) wedge resection, segmentectomy or lobectomy. There were 226 nodules in all patients. We analyzed the 4-hook needle localization safety, complications, safe margin and localization depth.
The 4-hook needle localizations success rate was 100% and didn't take place in displacement and dislodgment. The tumor margin distance is about 5-20 mm and all tumor margin was negative thorough final pathology result. 9 patients occurred small parenchymal hemorrhage, 13 patients occurred small pneumothorax and 8 patients occurred small hemoptysis, those complications needn't intervene or tackle and didn't affect surgery. Compared upper and middle lobe to lower lobe, localization time was 13.92 ± 4.6 min vs 13.66 ± 4.28 min respectively, p = 0.69, there was no significant statistical difference. Localization depth was 18.63 ± 7.8 mm vs 15.87 ± 8.52 mm respectively, p = 0.02, there were statistical differences, but the margin tumor distance was 5.16 ± 4.94 mm vs 4.93 ± 3.64 mm, p = 0.73 respectively, there was no statistical difference.
Preoperative 4-hook needle localization is safe and feasible for GGNs. Guided by 4-hook needle localization, wedge resection can ensure enough safe margins and patient was well tolerated.
本研究旨在评估四钩针定位法对肺磨玻璃结节（GGNs）的有效性。
从2021年11月1日至2024年5月31日，194例患者经计算机断层扫描（CT）诊断为一个或多个GGNs，并在术前接受CT引导下的四钩针定位，随后进行电视辅助胸腔镜手术（VATS）楔形切除术、肺段切除术或肺叶切除术。所有患者共有226个结节。我们分析了四钩针定位的安全性、并发症、安全切缘和定位深度。
四钩针定位成功率为100%，未发生移位和脱落。肿瘤边缘距离约为5 - 20毫米，最终病理结果显示所有肿瘤边缘均为阴性。9例患者出现小范围实质内出血，13例患者出现小范围气胸，8例患者出现小范围咯血，这些并发症无需干预或处理，且不影响手术。与上叶和中叶相比，下叶的定位时间分别为13.92 ± 4.6分钟和13.66 ± 4.28分钟，p = 0.69，无显著统计学差异。定位深度分别为18.63 ± 7.8毫米和15.87 ± 8.52毫米，p = 0.02，有统计学差异，但肿瘤边缘距离分别为5.16 ± 4.94毫米和4.93 ± 3.64毫米，p = 0.73，无统计学差异。
术前四钩针定位对GGNs是安全可行的。在四钩针定位引导下，楔形切除术可确保足够的安全切缘，且患者耐受性良好。
