A Comparison between Prethoracoscopy Localization of Small Pulmonary Nodules by Means of Medical Adhesive versus Hookwire

Abstract Purpose To compare prethoracoscopy localization of small pulmonary nodules (SPNs) by means of medical adhesive versus hookwire. Materials and Methods One hundred seven patients who underwent video-assisted thoracoscopic surgery resection for SPNs were consecutively recruited in this retrospective cohort study. Patients were divided into 2 groups according to the material used for localization of the SPNs: the medical adhesive group (n = 88) and the hookwire group (n = 19). The baseline data were collected, and operation waiting time (OWT; the time gap between localization and surgery), wedge resection performing time (WRPT), pathologic result, and complications of the 2 groups were assessed. Results All SPNs were successfully marked. No differences in pathologic result ( P  = .676), wedge resection, or segmentectomy rate ( P  = .679) were observed. OWT was markedly longer in the medical adhesive group than in the hookwire group ( P P  = .926). There were significantly ( P  = .004) fewer complications in the medical adhesive group (37.42%) than in the hookwire group (15.79%). Regarding individual complications, hemorrhage occurred significantly less in the medical adhesive group than in the hookwire group (9% vs 68%; P P > .05). Multivariate logistic regression analysis further validated that hookwire was independently correlated with a higher risk of complication occurrence ( P  = .008) and hemorrhage occurrence ( P Conclusions Compared with hookwire, localization via medical adhesive can achieve a flexible time gap between localization and surgery. It also decreases the complication rate and increases convenience owing to no need for an anchor hook.