Abstract
Background and Objectives: Clinically, a major challenge of multiple nodule localization is puncture-related pneumothorax, which may hamper the successful localization. This study aims to investigate and compare the efficacy and safety of the simultaneous and sequential patent blue dye (PBD) injections for identifying multiple pulmonary nodules during preoperative CT-guided localization. Materials and Methods: Sixty-one consecutive patients with multiple pulmonary nodules who underwent preoperative CT-guided localization with PBD injections between January 2020 and December 2020 were retrospectively enrolled. Of these patients, 31 patients with 64 nodules who underwent simultaneous injections were designated as the simultaneous group; the remaining 30 patients with 63 nodules who underwent sequential punctures were designated as the sequential group. The clinical and radiological features, technical information, pathological results, and procedure-related variables and complications of the two groups were reviewed and analyzed. Results: The localization success rate of the simultaneous group was higher than that of the sequential group (100% [64/64] vs. 93.7% [59/63], p = 0.041). The incidences of pneumothorax (32.3 vs. 33.3%, p = 0.929) and pulmonary hemorrhage (6.3 vs. 3.0%, p = 1) were not significantly different between the two groups, and all cases were minor, which did not require further intervention. Additionally, a significantly lower radiation dose (2.7 vs. 3.5 mSv, p = 0.001) and a shorter procedure time (20.95 vs. 25.28 min, p = 0.001) were observed in the simultaneous group than in the sequential group. Conclusions: Compared with the sequential method, simultaneous PBD injections may improve the localization success rate with a shorter procedure time and less radiation exposure if the patient with multiple pulmonary nodules can be approached in a single position. Further prospective studies are needed to validate these results.
Highlights
Low-dose computed tomography (LDCT) screening helps in diagnosing lung cancer earlier and leads to a decrease in mortality of these patients, so it is recommended for high-risk individuals [2,3]
We identified eligible patients with multiple indeterminate pulmonary nodules who underwent preoperative CT-guided localization with patent blue dye (PBD) followed by video-assisted thoracoscopic surgery (VATS) in our hospital from January 2020 to December 2020
The localization success rate in the simultaneous group was higher than that in the sequential group (100% [64/64] vs. 93.7% [59/63], p = 0.041)
Summary
Lung cancer is the leading cause of cancer death globally [1]. Low-dose computed tomography (LDCT) screening helps in diagnosing lung cancer earlier and leads to a decrease in mortality of these patients, so it is recommended for high-risk individuals [2,3]. The aim of the study was to compare the efficacy and safety of the simultaneous PBD injections with those of the sequential approach for patients with multiple pulmonary nodules. This study aims to investigate and compare the efficacy and safety of the simultaneous and sequential patent blue dye (PBD) injections for identifying multiple pulmonary nodules during preoperative CT-guided localization. Materials and Methods: Sixty-one consecutive patients with multiple pulmonary nodules who underwent preoperative CT-guided localization with PBD injections between January 2020 and December 2020 were retrospectively enrolled. Conclusions: Compared with the sequential method, simultaneous PBD injections may improve the localization success rate with a shorter procedure time and less radiation exposure if the patient with multiple pulmonary nodules can be approached in a single position.
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