Zhou Feng, Tao Jun, Shen Fei, Huang Xiang-Zhong, Huang Wen-Jia, Gao Fu-Lei
Department of Radiology, Jiangyin Hospital Affiliated to Nantong University, Jiangyin, China.
Department of Respiratory, Jiangyin Hospital Affiliated to Nantong University, Jiangyin, China.
Front Surg. 2025 May 9;12:1545503. doi: 10.3389/fsurg.2025.1545503. eCollection 2025.
Both Accura wire and soft anchored wire strategies can be employed for the preoperative computed tomography (CT)-guided localization of pulmonary nodules (PNs). The relative outcomes associated with these two distinct localization strategies, however, remain uncertain. This study thus sought to explore the relative safety and efficacy of preoperative CT-guided Accura wire and soft anchored wire localization for PNs.
This was a retrospective study enrolling patients from two centers. Consecutive patients with PNs who underwent preoperative CT-guided Accura wire or soft anchored wire localization followed by video-assisted thoracic surgery (VATS) resection between January 2022 and December 2023 were enrolled in these analyses. The comparison was carried out between these two groups to evaluate the safety and efficacy.
Over the course of this study, 190 patients were enrolled and classified into the Accura wire ( = 100) and soft anchored wire ( = 90) groups. One PN was localized per patient, and the respective technical success rates for these two localization strategies were 98% (98/100) and 100% ( = 0.497). Dislodgement accounted for the two technical failures in the Accura wire group. Comparison of both groups revealed a comparable median localization procedural duration (9.0 vs. 9.0 min, = 0.082), while the soft anchored wire group presented with visual analog scale scores significantly lower than those for the Accura wire group (3.0 ± 0.6 vs. 4.5 ± 0.6, = 0.001). Significantly reduced pneumothorax (16.7% vs. 41%, = 0.001) and pulmonary hemorrhage (23.3% vs. 41%, = 0.01) rates were noted for the soft anchored wire relative to the Accura wire. VATS-guided limited resection was successfully performed for all patients.
Both Accura wire and soft anchored wire strategies can facilitate accurate PN localization prior to VATS, although the latter strategy may be associated with a better safety profile relative to the former.
精准导丝和软锚定导丝策略均可用于术前计算机断层扫描（CT）引导下的肺结节（PN）定位。然而，这两种不同定位策略的相关结果仍不确定。因此，本研究旨在探讨术前CT引导下精准导丝和软锚定导丝定位PN的相对安全性和有效性。
这是一项来自两个中心的回顾性研究。纳入2022年1月至2023年12月期间接受术前CT引导下精准导丝或软锚定导丝定位并随后行电视辅助胸腔镜手术（VATS）切除的连续PN患者进行分析。对这两组进行比较以评估安全性和有效性。
在本研究过程中，190例患者入组并分为精准导丝组（n = 100）和软锚定导丝组（n = 90）。每位患者定位1个PN，这两种定位策略各自的技术成功率分别为98%（98/100）和100%（P = 0.497）。精准导丝组的2例技术失败是由导丝移位所致。两组比较显示，定位操作的中位持续时间相当（9.0 vs. 9.0分钟，P = 0.082），而软锚定导丝组的视觉模拟量表评分显著低于精准导丝组（3.0±0.6 vs. 4.5±0.6，P = 0.001）。相对于精准导丝，软锚定导丝的气胸（16.7% vs. 41%，P = 0.001）和肺出血（23.3% vs. 41%，P = 0.01）发生率显著降低。所有患者均成功进行了VATS引导下的局限性切除。
精准导丝和软锚定导丝策略均可在VATS术前促进PN的准确定位，尽管后一种策略相对于前一种策略可能具有更好的安全性。
