Safety,effectiveness and influencing factors of CT-guided percutaneous puncture with methylene blue and bio-glue for localizing pulmonary nodules
Objective To examine the safety,effectiveness,and influencing factors of CT-guided methylene blue and bio-glue preoperative assisted lung nodule localization technique.Methods Data of 230 cases of CT-guided methylene blue and bio-glue preoperative lung nodule localization operations completed in the Cancer Hospital of Chinese Academy of Medical Sciences between May 2023 and February 2024 were collected,including patient basic information,intraoperative technical parameters,and occurrence of intraoperative complications.The success rate of the technique and the incidence of intraoperative complications were analyzed,and the potential influencing factors of localization success rate and major complications(pneumothorax)were analyzed with logistic regression analysis.Results Among the 230 cases,the localization success rate was 84.3％(194 cases).The most common intraoperative complication was pneumothorax,with an incidence rate of 10.4％(24 cases),while the incidence rates of pulmonary hemorrhage and pleural reaction were lower,at 6.1％(14 cases)and 0.9％(2 cases)respectively.Multivariate logistic regression analysis showed that the only risk factor leading to localization failure was the occurrence of intraoperative pneumothorax(OR=6.528,95％CI:1.974～21.585,P=0.002).Nodule located in the lower lobe of the lung(OR=0.163,95％CI:0.040～0.671,P=0.012),lateral decubitus position for localization(OR=6.163,95％CI:1.430～26.562,P=0.015),and pain level ≥6(OR=0.353,95％CI:0.127～0.980,P=0.046)were independent risk factors for intraoperative pneumothorax.Conclusions Our data show that CT-guided methylene blue and bio-glue preoperative assisted lung nodule localization technique is a safe and effective preoperative assisted localization technique.The occurrence of pneumothorax is the most significant factor affecting localization success rate,and avoiding lateral decubitus position and implementing more effective anesthesia and pain control can reduce the incidence of pneumothorax during localization,thereby increasing the success rate of localization.
Preoperative localization of pulmonary nodulesCT assisted localizationMethylene blueBio-gluePneumothorax
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