Comparison between the application of dyed medical glue and hookwires for the localization of pulmonary nodules.

Objectives: To compare the efficacy and safety of the localization of small pulmonary nodules (sPNs) with dyed medical glue (DMG) and hookwires prior to video-assisted thoracoscopic surgery (VATS). Materials and methods: A total of 344 patients were enrolled in this single-center retrospective cohort study between January 2018 and May 2022. There were 184 patients who underwent localization with DMG. From this amount, 160 patients underwent localization with hookwires. The localization success rate, localization-VATS interval time (LVIT), surgical resection time (SRT), and complications of the two groups were assessed. Results: VATS was successfully performed in all cases without conversion to thoracotomy. The localization success rate showed that the DMG group (100%, 184/184) had better results than the hookwire group (91.3%, 146/160) (P=0.004). The dyed glue group had a longer LVIT (P < 0.001) and shorter SRT (P=0.042). The rates of pulmonary hemorrhage (P < 0.001) and overall complications (P=0.009) in the DMG group were significantly lower than those in the hookwire group. An increased number of needle adjustments in the lung was associated with an increased incidence of pneumothorax (P=0.005), pulmonary hemorrhage (P=0.037), and overall complications (P=0.001). The prolonged time required for positioning was associated with an increased incidence of chest pain (P=0.002). Conclusions: Localization using DMG and hookwires is equally safe and effective for sPNs prior to resection with VATS. DMG localization was associated with fewer complications and resulted in a longer LVIT.