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Comparison of cyanoacrylate and hookwire for localizing small pulmonary nodules: A propensity-matched cohort study.
Int J Surg 2019; 71:49-55IJ

Abstract

BACKGROUND

Localizing small pulmonary nodules (SPNs) is a challenge during thoracoscopic resection, but preoperative computed tomography (CT)-guided localization using either cyanoacrylate or hookwire can be helpful. This study compared the safety, efficiency, and operability of the two techniques.

METHODS

From September 2013 to November 2018, 269 patients (269 SPNs) who underwent preoperative CT-guided SPN localization were enrolled. A propensity-matched analysis, incorporating 13 variables, was performed to control potential selection bias.

RESULTS

All the patients were divided into two groups: CT-guided cyanoacrylate localization group (Group C, n = 149) and CT-guided hookwire localization group (Group H, n = 120). Eighty-six patients were propensity-matched in each group. All SPNs were successfully removed thoracoscopically, and no conversion was required. Localization-related complications in the two groups were similar, including intrapulmonary focal hemorrhage (p = 0.823), pneumothorax (p = 1.000), or hemoptysis (p = 0.121). For pain assessment and management, the cyanoacrylate localization saw a lower pain score (p < 0.001) and less morphine use (p < 0.001). In Group H, the localization took a significantly longer time (p < 0.001). Covering only the patients in Group C, the sub-analysis found that cyanoacrylate localization on the day before surgery did not compromise the accuracy of intraoperative targeting or increase the incidence of complications, compared with the localization on the day of surgery (all p > 0.05).

CONCLUSION

Compared to hookwire localization, CT-guided cyanoacrylate localization decreased pain and morphine use and allowed flexible surgical schedules, suggestive of its preferability for the resection of SPNs.

Authors+Show Affiliations

Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. Electronic address: yaofei@njmu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31521836

Citation

Wang, Jian, et al. "Comparison of Cyanoacrylate and Hookwire for Localizing Small Pulmonary Nodules: a Propensity-matched Cohort Study." International Journal of Surgery (London, England), vol. 71, 2019, pp. 49-55.
Wang J, Yao J, Xu L, et al. Comparison of cyanoacrylate and hookwire for localizing small pulmonary nodules: A propensity-matched cohort study. Int J Surg. 2019;71:49-55.
Wang, J., Yao, J., Xu, L., Shan, L., Zhai, R., Gao, L., ... Yao, F. (2019). Comparison of cyanoacrylate and hookwire for localizing small pulmonary nodules: A propensity-matched cohort study. International Journal of Surgery (London, England), 71, pp. 49-55. doi:10.1016/j.ijsu.2019.09.001.
Wang J, et al. Comparison of Cyanoacrylate and Hookwire for Localizing Small Pulmonary Nodules: a Propensity-matched Cohort Study. Int J Surg. 2019 Sep 12;71:49-55. PubMed PMID: 31521836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of cyanoacrylate and hookwire for localizing small pulmonary nodules: A propensity-matched cohort study. AU - Wang,Jian, AU - Yao,Ju, AU - Xu,Lei, AU - Shan,Limei, AU - Zhai,Rong, AU - Gao,Libing, AU - Liu,Liang, AU - Yao,Fei, Y1 - 2019/09/12/ PY - 2019/05/21/received PY - 2019/08/19/revised PY - 2019/09/06/accepted PY - 2019/9/16/pubmed PY - 2019/9/16/medline PY - 2019/9/16/entrez KW - Computed tomography-guided localization KW - Cyanoacrylate KW - Hookwire KW - Small pulmonary nodule SP - 49 EP - 55 JF - International journal of surgery (London, England) JO - Int J Surg VL - 71 N2 - BACKGROUND: Localizing small pulmonary nodules (SPNs) is a challenge during thoracoscopic resection, but preoperative computed tomography (CT)-guided localization using either cyanoacrylate or hookwire can be helpful. This study compared the safety, efficiency, and operability of the two techniques. METHODS: From September 2013 to November 2018, 269 patients (269 SPNs) who underwent preoperative CT-guided SPN localization were enrolled. A propensity-matched analysis, incorporating 13 variables, was performed to control potential selection bias. RESULTS: All the patients were divided into two groups: CT-guided cyanoacrylate localization group (Group C, n = 149) and CT-guided hookwire localization group (Group H, n = 120). Eighty-six patients were propensity-matched in each group. All SPNs were successfully removed thoracoscopically, and no conversion was required. Localization-related complications in the two groups were similar, including intrapulmonary focal hemorrhage (p = 0.823), pneumothorax (p = 1.000), or hemoptysis (p = 0.121). For pain assessment and management, the cyanoacrylate localization saw a lower pain score (p < 0.001) and less morphine use (p < 0.001). In Group H, the localization took a significantly longer time (p < 0.001). Covering only the patients in Group C, the sub-analysis found that cyanoacrylate localization on the day before surgery did not compromise the accuracy of intraoperative targeting or increase the incidence of complications, compared with the localization on the day of surgery (all p > 0.05). CONCLUSION: Compared to hookwire localization, CT-guided cyanoacrylate localization decreased pain and morphine use and allowed flexible surgical schedules, suggestive of its preferability for the resection of SPNs. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/31521836/Comparison_of_cyanoacrylate_and_hookwire_for_localizing_small_pulmonary_nodules:_a_propensity-matched_cohort_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(19)30228-6 DB - PRIME DP - Unbound Medicine ER -