Clinical Application Study Of CT-Guided Pulmonary Nodule Needle For Preoperative Localization Of Solitary Pulmonary Nodules

Objective(s): The application value of CT-guided pulmonary nodule positioning needle for preoperative localization of solitary pulmonary nodule(SPN)in Video-assisted thoracoscopic resection(VATS)was observed,and also the localization effects were observed.Methods: The clinical data of 342 patients with solitary pulmonary nodules(the maximum diameter from 0.5 cm to 1.5 cm)who underwent VATS at the First People’s Hospital of Yunnan Province from September 2020 to September 2022 were retrospectively analyzed.A total of 242 patients in the observation group received localization with pulmonary nodule positioning needle within 48 h before surgery,while 100 patients in the control group did not.The operative time and postoperative hospital stay of VATS were used to evaluate the effectiveness of localization,and the intraoperative blood loss was used to evaluate the safety of VATS.The influencing factors of localization accuracy were analyzed,and the risk factors of localization complications were evaluated.Results: All lesions of patients were successfully resected by VATS.Intraoperative blood loss,operation time and postoperative hospital stay in the observation group were all less than those in the control group(P<0.001).All 242 pulmonary nodules in the observation group were implanted with anchor positioning needle,and 1 case had embedding soft wire after needle withdrawal.Therefore,the success rate of positioning was 99.59%(241/242).The location of pulmonary nodules in the lower lobes of both lungs,the puncture depth in the lung,and the angle between the puncture needle and the horizontal plane were all factors influencing the localization accuracy(P<0.05).Pleural indentation and chronic obstructive pulmonary disease were independent risk factors for localized pneumothorax(P<0.05).Intrapulmonary puncture depth(≥2 cm)was an independent risk factor for pulmonary hemorrhage(P< 0.001).Conclusion(s): The safety,effectiveness and accuracy of CT-guided localization of isolated pulmonary nodules with pulmonary nodule positioning needle are good,with few and minor complications.Positioning needle technology for SPN positioning before VATS can not only facilitate the surgeon to explore the lesion and accurately remove it,but also significantly reduce intraoperative blood loss,operation time and postoperative hospital stay,and facilitate the postoperative recovery of patients,which has good clinical application value.