Page 65 - JCTR-11-2

Journal of Clinical and
Translational Research CT-guided needle versus glue localization

localization procedures. Moreover, in patients with 5. Conclusion
small nodules, the increased technical difficulty often
necessitates multiple adjustments in needle angle or For preoperative localization of pulmonary nodules, both
depth, thereby elevating the number of pleural punctures. CT-guided pulmonary nodule localization needles and
Yao et al. found that an increased number of puncture medical glue are safe and effective, but it is crucial to note
34
attempts during hook-wire localization is an independent the distinctive set of advantages and disadvantages of
risk factor for pneumothorax. Multiple punctures may each method. Medical glue is preferable for patients with
create more holes in the visceral pleura, compromising emphysema, bullae, poor pain tolerance, long puncture
its integrity and increasing the risk of air entering the paths, or longer intervals between localization and surgery.
pleural cavity, leading to pneumothorax. Similarly, analysis In contrast, the pulmonary nodule localization needle
in this study shows significant differences between the is more suitable for patients with COPD or asthma.
intrapulmonary hemorrhage and non-hemorrhage groups Intrapulmonary hemorrhage is associated with localization
concerning puncture attempts, lung disease history, and time, puncture depth, lung disease history, and puncture
localization time. These findings align with other studies. attempts, while pneumothorax is related to lung disease
35
Intrapulmonary hemorrhage likely occurs due to the rich history, nodule size, localization method, and puncture
vascularity of the lungs, with puncture needles potentially attempts.
damaging small pulmonary vessels. An increased number
of punctures raises the risk of vascular injury, thereby Acknowledgments
elevating the risk of hemorrhage. Proper lesion assessment We are deeply grateful to the medical team (physicians,
and route planning before puncture can minimize nurses, and anesthesiology staff) at the First Affiliated
failure and reduce the incidence of pneumothorax and Hospital of Guangxi Medical University for their
intrapulmonary hemorrhage. Patients with a history of professional expertise and tireless efforts in supporting this
lung diseases may be more prone to hemorrhage during research.
puncture procedures due to reduced alveolar wall elasticity
and abnormal vascular distribution. 32,33 Additionally, Funding
prolonged puncture times may induce increased anxiety This work was supported in part by Self-financed Scientific
and stress in patients, which can compromise the stability Research of Guangxi Zhuang Autonomous Region Health
of the localization process and further elevate the risk of
pulmonary hemorrhage. Commission (Z20211032), Guangxi Medical and Health
Appropriate Technology Development and Popularization
Our study has several limitations. First, our adhesive Application Project (S2022070), the Joint Project on
protocol was standardized based on previous literature, Regional High-Incidence Diseases Research of Guangxi
and we did not systematically evaluate modifications— Natural Science Foundation (2024GXNSFBA010032), the
such as reducing the injected volume or altering the Youth Science Foundation of Guangxi Medical University
formulation—to minimize the adhesive’s irritative (GXMUYSF202420), the National Key Clinical Specialty
reaction. Although the glue group exhibited lower Construction Project, Guangxi Medical and Health Key
pain scores compared to the needle group, further Discipline Construction Project and Guangxi Key Clinical
optimization of the adhesive parameters may enhance Specialty Construction Project.
the safety and tolerability of the localization technique.
Second, while the use of localization markers ensured Conflict of interest
that all lesions were readily identified during surgery, There are no conflicts of interest.
thereby achieving our localization objectives, the
retrospective design precluded the collection of Author contributions
quantitative data to assess differences in marker stability
between the localization procedure and surgery. This Conceptualization: Zhanyu Xu, Jianji Guo
limitation represents a promising direction for future Formal analysis: Zehao Huang, Nuo Yang
research. Finally, the retrospective nature of our study Investigation: Yihua Huang, Zehao Huang, Huajian Peng,
introduces inherent limitations, including potential Xu Feng
selection bias and confounding factors that may affect Methodology: Zhanyu Xu, Yihua Huang
the generalizability of our findings. Future prospective Supervision: Xu Feng, Nuo Yang, Jianji Guo
studies with standardized protocols are warranted to Writing – original draft: Zhanyu Xu
validate these results and further mitigate potential Writing – review & editing: Jun Liu, Xu Feng, Nuo Yang,
biases. Jianji Guo

Volume 11 Issue 2 (2025) 59 doi: 10.36922/JCTR025070007