Background Accurate preoperative localization is crucial to improving the success rates of thoracoscopic surgery and minimizing postoperative complications. Hook-wire localization can be inaccurate when marking small pulmonary nodules near the fissures of the lungs. This study aims to evaluate the accuracy and safety of indocyanine green (ICG) staining combined with electromagnetic navigation bronchoscopy (ENB) compared to hook-wire percutaneous localization for pulmonary nodules near the fissures. Methods A retrospective analysis was conducted on 64 patients who underwent video-assisted thoracic surgery (VATS). The patients were divided into two groups: Group A (ENB with ICG staining) and Group B (hook-wire percutaneous localization). The two groups were compared for localization time, complication rates, specimen retrieval time, and the need for extended resection. Results The ENB group required more time for localization than the hook-wire group (25.30 min vs. 19.68 min, P 0.05). However, only one case in the ENB group required further resection (3.0% vs. 22.6%, P = 0.018). The incidence of pneumothorax was significantly lower in the ENB group than in the hook-wire group (6.10% vs. 25.80%, P = 0.03). Conclusion ENB combined with ICG staining for localization of nodules near the fissures significantly reduces the likelihood of extended resection and is associated with a higher safety profile compared to hook-wire percutaneous localization.
Gong et al. (Wed,) studied this question.