The efficacy of the 4-hook needle localization for pulmonary ground glass nodules: a single-center retrospective analysis.

INTRODUCTION

The aim of this study was to evaluate the efficacy of the 4-hook needle localization for pulmonary ground glass nodules (GGNs).

METHODS

From November 1, 2021, to May 31, 2024, 194 patients were diagnosed with one or more GGNs by computed tomography (CT) scan and underwent preoperative CT-guided 4-hook needle localization followed by video-assisted thoracoscope surgery (VATS) wedge resection, segmentectomy or lobectomy. There were 226 nodules in all patients. We analyzed the 4-hook needle localization safety, complications, safe margin and localization depth.

RESULTS

The 4-hook needle localizations success rate was 100% and didn't take place in displacement and dislodgment. The tumor margin distance is about 5-20 mm and all tumor margin was negative thorough final pathology result. 9 patients occurred small parenchymal hemorrhage, 13 patients occurred small pneumothorax and 8 patients occurred small hemoptysis, those complications needn't intervene or tackle and didn't affect surgery. Compared upper and middle lobe to lower lobe, localization time was 13.92 ± 4.6 min vs 13.66 ± 4.28 min respectively, p = 0.69, there was no significant statistical difference. Localization depth was 18.63 ± 7.8 mm vs 15.87 ± 8.52 mm respectively, p = 0.02, there were statistical differences, but the margin tumor distance was 5.16 ± 4.94 mm vs 4.93 ± 3.64 mm, p = 0.73 respectively, there was no statistical difference.

CONCLUSIONS

Preoperative 4-hook needle localization is safe and feasible for GGNs. Guided by 4-hook needle localization, wedge resection can ensure enough safe margins and patient was well tolerated.