Comparing four-hook and double-hook localization needles in preoperative pulmonary nodule positioning: efficacy, safety, and patient perception.

Background: Precise preoperative localization is crucial for improving the success rate and reducing the duration of thoracoscopic surgeries. This study aimed to evaluate the efficacy, safety, and patient perception of the four-hook localization needle compared to the traditional double-hook localization needle in the localization of pulmonary nodules.

Methods: We conducted a retrospective analysis of 207 patients who underwent video-assisted thoracoscopic surgery (VATS). Seventy-six patients used a four-hook localization needle preoperatively, while 121 patients used the traditional double-hook needle. Propensity score matching was employed to balance the baseline characteristics of the two groups and minimize confounding bias. We compared the surgery success rate, surgical field success rate, complication rate, and post-localization respiratory pain score between the two groups.

Results: Both localization methods achieved a 100% success rate. The four-hook needle had a statistically significant shorter localization time (20.00 min vs. 21.00 min, P = 0.046) and a lower preoperative displacement rate (5.81% vs. 17.36%, P = 0.014) compared to the double-hook needle. Both before and after propensity score matching, the postoperative respiratory pain score was significantly lower in the four-hook group compared to the double-hook group (P < 0.001). After balancing baseline characteristics, univariate (P = 0.036) and multivariate (P = 0.039) logistic regression analyses indicated that the four-hook group had a significantly lower risk of localization complications compared to the double-hook group.

Conclusions: The four-hook localization needle outperforms the traditional double-hook needle due to its shorter localization time, lower post-localization respiratory pain score, and reduced displacement rate, making it a simpler and safer option. Furthermore, the four-hook needle effectively reduces the risk of complications, presenting a promising method for preoperative localization of pulmonary nodules.