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Introduction: In patients with pulmonary nodules (PNs), computed tomography (CT)-guided localization is commonly performed prior to the resection of these nodules through video-assisted thoracic surgery (VATS). Aim: To evaluate the relative clinical efficacy of coil and anchored needle (AN) insertion as approaches to preoperative CT-guided PN localization. Material and methods: This single-center, prospective, open-label, randomized controlled trial (registration number: NCT05183945) enrolled consecutive patients from January 2022 to July 2022, assigning these patients at random to undergo either coil or AN localization prior to VATS. Efficacy and safety outcomes in these two groups were then compared. Results: This study enrolled in total 100 patients with 120 PNs who were assigned at random to the coil (patients = 50; PNs = 60) and AN (patients = 50; PNs = 60) localization groups. The respective technical success rates for coil and AN localization were 98.3% (59/60) and 100% (60/60), with no significant difference between the groups (p = 1.000). The coil group had a significantly longer median duration of localization relative to the AN group (16.0 min vs. 8.0 min, p < 0.001). Similar rates of localization-related pneumothorax (8.3% vs. 5.0%, p = 0.715) and pulmonary hemorrhage (5.0% vs. 13.3%, p = 0.110) were observed in both groups. In addition, the VATS resection procedures achieved 100% technical success rates in both of these localization groups. Conclusions: Both coil- and AN-based localization approaches can be successfully employed to localize PNs prior to VATS resection, with the AN localization procedure requiring less time to complete on average as compared to the coil-based approach. [ABSTRACT FROM AUTHOR]

Introduction: The diagnosis of pulmonary nodules (PNs) has traditionally relied on computed tomography (CT)-guided biopsy. To reduce radiation exposure, low-dose CT-guided PN biopsy has been employed. Aim: This meta-analysis aimed at evaluating the efficacy and safety of low-dose CT-guided biopsy in the diagnosis of PNs. Material and methods: PubMed, Web of Science, and Wanfang were searched for relevant articles until June 2023. Comparing low-dose CT to normal-dose CT, we considered factors such as diagnostic yield, diagnostic accuracy, biopsy process time, dose-length product (DLP) value, the frequency of pneumothorax and pulmonary bleeding, and the frequency with which complications necessitated the placement of a chest tube. Results: This meta-analysis included data from a total of 6 investigations. There was a total of 459 patients who had a CT-guided PN biopsy performed at a low dosage, and 384 patients who had a normal-dose CT-guided PN biopsy. There were no statistically significant differences between the low-dose CT and normal-dose CT groups in terms of diagnostic accuracy (p = 0.08), diagnostic yield (p = 0.55), biopsy procedure duration (p = 0.30), pneumothorax (p = 0.61), pulmonary hemorrhage (p = 0.29), or complications requiring a chest tube (p = 0.48). Low-dose CT patients obtained a DLP that was 91% lower than those in the standard-dose CT group (p = 0.01). According to Egger's test, there is a significant possibility of publication bias in DLP (p = 0.034). Conclusions: The diagnostic and safety results of low-dose CT-driven PN biopsy are equivalent to those of the standard one, although patients are much less exposed to radiation. [ABSTRACT FROM AUTHOR]

Introduction: Both computed tomography (CT)-guided and bronchoscopic localization strategies have been utilized prior to video-assisted thoracic surgery (VATS) as a means of achieving high lung nodule (LN) wedge resection success rates. Aim: The present meta-analysis was thus developed for the assessment of the efficacy and safety of preoperative CT-guided and bronchoscopic LN localization approaches. Material and methods: The PubMed, Cochrane Library, Embase, and Wanfang databases were searched for all relevant studies published through May 2022, with RevMan v5.3 being used to conduct pooled analyses of data pertaining to all endpoints of interest. Results: In total, this meta-analysis incorporated data from 7 retrospective studies including 321 patients bearing 353 LNs that underwent CT-guided localization and 220 patients bearing 244 LNs that underwent bronchoscopic localization. When comparing the CT and bronchoscopic localization approaches, pooled rates of technical success (p = 0.20) and duration of localization (p = 0.20) were comparable. However, bronchoscopic localization was associated with significantly lower pooled rates of pneumothorax (p < 0.001) and pulmonary hemorrhage (p = 0.005) relative to CT-guided localization. In the CT group, the pooled VATS duration was significantly shorter compared with the bronchoscopic group (p = 0.04), although the pooled duration of postoperative hospitalization was comparable in both groups (p = 0.69). The heterogeneity was significant with respect to both the duration of localization (I² = 97%) and the duration of postoperative hospitalization (I² = 74%). Conclusions: Relative to a CT-guided localization approach, the bronchoscopic localization of LNs can achieve similar clinical efficacy and superior safety. [ABSTRACT FROM AUTHOR]