Li Xiaofeng, Bai Xuepeng, Xu Li, Zhu Jiankun, Zhang Fan, Shen Changming, Jin Feng, Zhang Yunzeng
Department of Thoracic Surgery, Shandong Public Health Clinical Center, Shandong University, Shandong, China.
Department of Respiratory Endoscopy, Shandong Public Health Clinical Center, Shandong University, Shandong, China.
Wideochir Inne Tech Maloinwazyjne. 2025 Jan 15;20(1):61-68. doi: 10.20452/wiitm.2025.17930. eCollection 2025 Apr 9.
Both virtual bronchoscopic navigation (VBN) and puncture with a 4‑hook localization needle are viable methods for localizing pulmonary nodules. However, there is a paucity of research that compares these 2 approaches.
This study aimed to assess and compare the efficacy of and complications associated with these 2 approaches to pulmonary nodule localization.
We analyzed 223 patients who underwent VBN (n = 98) or needle localization (n = 125) of pulmonary nodules between April 2020 and December 2022. Each study group was divided into 2 subgroups, namely the solitary‑nodule group and the 2‑nodule group. We collected and analyzed data on localization time, accuracy, success rate, and complications in each group.
In the solitary‑nodule subgroup, the mean (SD) distance between the localization point and the pulmonary nodule was 6.2 (6.1) mm for the needle‑localization group and 8.6 (4.8) mm for the VBN‑localization group (P = 0.01). In the 2‑nodule subgroup, the mean (SD) distance did not significantly differ and amounted to 8.7 (4.6) mm for the needle‑localization group and 8.4 (4.4) mm for the VBN‑localization group. However, the mean (SD) time required for localization was shorter in the VBN‑localization group (17.2 [2.6] min) than in the needle‑localization group (26.6 [3.9] min; P <0.001), which indicated that VBN was more efficient in 2‑nodule localization. The solitary nodule- and 2‑nodule-localization procedures differed significantly in terms of complications, such as pneumothorax and bleeding, with fewer complications reported in the VBN‑localization group.
In comparison with needle localization, VBN localization was associated with fewer complications. In the case of 2 pulmonary nodules, VBN localization outperformed the needle approach, with shorter localization time, fewer complications, and no radiation exposure.
虚拟支气管镜导航（VBN）和使用4钩定位针穿刺都是定位肺结节的可行方法。然而，比较这两种方法的研究较少。
本研究旨在评估和比较这两种肺结节定位方法的疗效及相关并发症。
我们分析了2020年4月至2022年12月期间接受VBN（n = 98）或针定位（n = 125）肺结节的223例患者。每个研究组又分为两个亚组，即孤立结节组和双结节组。我们收集并分析了每组的定位时间、准确性、成功率和并发症数据。
在孤立结节亚组中，针定位组定位点与肺结节之间的平均（标准差）距离为6.2（6.1）mm，VBN定位组为8.6（4.8）mm（P = 0.01）。在双结节亚组中，平均（标准差）距离无显著差异，针定位组为8.7（4.6）mm，VBN定位组为8.4（4.4）mm。然而，VBN定位组的平均（标准差）定位时间（17.2 [2.6]分钟）比针定位组（26.6 [3.9]分钟；P <0.001）短，这表明VBN在双结节定位中更有效。孤立结节和双结节定位程序在气胸和出血等并发症方面有显著差异，VBN定位组报告的并发症较少。
与针定位相比，VBN定位的并发症较少。对于两个肺结节的情况，VBN定位优于针定位方法，定位时间更短，并发症更少，且无辐射暴露。
