Preoperative computed tomography-guided localization of pulmonary ground‑glass nodules: a comparison of conventional and soft hook‑wires.

Introduction: Hook-wire (HW) localization is the most frequently employed approach for preoperative localization of pulmonary ground-glass nodules (GGNs); however, the relative outcomes of conventional and soft HW localization of GGNs remain poorly understood.

Aim: This study sought to compare the safety and efficacy of preoperative computed tomography-guided conventional and soft HW localization of pulmonary GGNs.

Materials and methods: Between January 2023 and June 2024, consecutive patients with pulmonary GGNs underwent conventional or soft HW localization prior to video-assisted thoracoscopic surgery. Safety and clinical efficacy of these 2 localization strategies were compared.

Results: In total, 88 patients underwent conventional HW localization of 95 GGNs, and 82 patients underwent soft HW localization of 88 GGNs. Technical success rates for the conventional and soft HW groups were 96.8% and 100%, respectively (P = 0.25), and the duration of localization was similar in both groups (mean [SD], 10.1 [4.5] vs 10 [5.9] min; P = 0.97). Complications were significantly more common in the conventional HW group than in the soft HW group (48.9% vs 32.9%, respectively; P = 0.04). Visual analog scale scores in the conventional HW group were significantly higher than those observed in the soft HW group (mean [SD], 4.6 [0.6] vs 3.4 [0.6]; P = 0.001). The rates of technical success for limited resection procedures were similar in both groups (96.8% vs 100% in the conventional and soft HW groups, respectively; P >0.99).

Conclusions: Conventional and soft HW strategies can both effectively facilitate preoperative pulmonary GGN localization, but the soft HW approach has a more favorable safety profile.