The Comparison Of Methylene Blue And Micro-coils In CT-guided Preoperative Localization Of Small Pulmonary Nodules

Objective:To evaluate the clinical value of methylene blue and micro-coils in CT-guided preoperative localization of small pulmonary nodules in video-assisted thoracoscopic surgery.Methodes:We retrospectively analyzed clinical data of small pulmonary nodules who were treated by the video-assisted thoracoscopic surgery with preoperative CT guided methylene blue(24 patients,26 SPNs)or micro-coils(21 patients,22 SPNs)localization in our hospital from Jan 2016 to Jan 2017.We compared the success rate of localization,the pulmonary wedge resection rate without pathological results,the time of preoperative localization,operation time,cost and the incidence of preoperative localization complications(including pneumothorax,pulmonary hemorrhage and pleural reaction).Results: The success rate of localization of the methylene blue group was significantly higher than the micro-coils group(methylene blue group : 25 SPNs,96.2% vs micro-coils group : 16 SPNs,72.7%;P=0.038).The pulmonary wedge resection rate without pathological results of the methylene blue group was significantly higher than the micro-coils group(methylene blue group : 26 SPNs,100.0% vs micro-coils group : 17 SPNs,77.3%;P=0.015).The cost of the methylene blue group was less than the micro-coils group(methylene blue group : 1164 yuan vs micro-coils group :2585 yuan).In the preoperative localization time,the methylene blue group(20.35±2.65min)was less than micro-coils group(22.45±3.16min),but the difference was without statistically significant.In the operation time,the methylene blue group(121±30min)was less than micro-coils group(143±47min),but the difference was without statistically significant.In the incidence of preoperative localization complications,the pneumothorax rate of the methylene blue group(8.3%)was less than the micro-coils group(19.0%),but the difference was without statistically significant.In the pleural reaction rate,the methylene blue group(8.3%)was greater than the micro-coils group(4.8%),but the difference was without statistically significant.Conclusion: Preoperative CT guided methylene blue localization of small pulmonary nodules in video-assisted thoracoscopic surgery had a higher success rate and was cheaper and safer.It is more suitable for application as the localization method of small pulmonary nodules in thoracoscopic wedge resection.