Preoperative computed tomography guided coil versus suture hook-wire localization for multiple pulmonary nodules.

BACKGROUND

Computed tomography (CT)-guided insertion of coil and suture hook-wire (SHW) insertion is commonly used for preoperative localization of multiple pulmonary nodules (PNs). However, the relative clinical efficacy and safety of these two methods have not been established. This study aimed to evaluate and compare the clinical performance and safety profiles of coil- and SHW-based localization techniques in patients with multiple PNs.

METHODS

A retrospective analysis was conducted on patients with multiple PNs who underwent CT-guided coil or SHW localization followed by video-assisted thoracic surgery (VATS) resection between January 2020 and December 2024. Outcomes related to localization and VATS procedure parameters were compared.

RESULTS

A total of 35 patients (76 PNs) in the coil group and 37 patients (81 PNs) in the SHW group were retrospectively analyzed. Both groups achieved a 100% technical success rate for localization. The average time required for CT-guided localization was significantly shorter in the SHW group compared to the coil group (24.0 ± 12.3 min vs. 29.3 ± 9.0 min, P = 0.042). The incidence of pneumothorax was comparable between the 2 groups (25.7% for coil vs. 29.7% for SHW, P = 0.704). VATS-guided limited resection was successfully performed in all cases across both groups, with each patient undergoing complete one-stage resection of multiple PNs. The median VATS duration (130 min vs. 90 min, P = 0.084) and blood loss (25 ml vs. 50 ml, P = 0.152) were also similar in both groups.

CONCLUSIONS

These findings indicate that both CT-guided coil and SHW localization techniques are safe and effective for the preoperative localization of multiple PNs. However, SHW localization provides a significant advantage by significantly shortening the procedure duration compared to the coil localization.