Preoperative localization for pulmonary nodules: a meta-analysis of coil and liquid materials

This study was designed to conduct pooled comparisons of the relative clinical efficacy and safety of computed tomography (CT)-guided localization for pulmonary nodules (PNs) using either coil- or liquid material-based approaches. Relevant articles published as of July 2023 were identified in the Web of Science, PubMed, and Wanfang databases, and pooled analyses of relevant endpoints were then conducted. Six articles that enrolled 287 patients (341 PNs) and 247 patients (301 PNs) that had respectively undergone CT-guided localization procedures using coil- and liquid material-based approaches prior to video-assisted thoracic surgery (VATS) were included in this meta-analysis. The liquid material group exhibited a significantly higher pooled successful localization rate as compared to the coil group (<i>p</i> = 0.01), together with significantly lower pooled total complication rates (<i>p</i> = 0.0008) and pneumothorax rates (<i>p</i> = 0.01). Both groups exhibited similar rates of pulmonary hemorrhage (<i>p</i> = 0.44) and successful wedge resection (<i>p</i> = 0.26). Liquid-based localization was also associated with significant reductions in pooled localization and VATS procedure durations (<i>p</i> = 0.004 and 0.007). These data are consistent with CT-guided localization procedures performed using liquid materials being safer and more efficacious than coil-based localization in patients with PNs prior to VATS resection.

本研究旨在对比电视辅助胸腔镜手术（video-assisted thoracic surgery, VATS）术前，采用线圈类或液体材料类方法行经计算机断层扫描（computed tomography, CT）引导下肺结节（pulmonary nodules, PNs）定位术的相对临床疗效与安全性。研究人员检索了截至2023年7月发表于Web of Science、PubMed及万方数据库的相关文献，并对相关终点指标开展合并分析。本次荟萃分析共纳入6项研究，其中线圈类定位组纳入287例患者（共341个肺结节），液体材料定位组纳入247例患者（共301个肺结节），所有受试者均于VATS术前接受CT引导下定位术。数据分析结果显示，相较于线圈组，液体材料组的合并定位成功率显著更高（p=0.01），合并总并发症发生率（p=0.0008）和气胸发生率（p=0.01）均显著更低；两组的肺出血发生率（p=0.44）与楔形切除术成功率（p=0.26）无显著差异。此外，液体材料定位组的合并定位手术时长及VATS手术时长均显著缩短（p=0.004和0.007）。上述研究数据表明，相较于线圈类定位术，采用液体材料行经CT引导下肺结节定位术在VATS术前患者中具备更优的安全性与有效性。