Analysis on the application of a CT-guided medical adhesive-based localization method in sublobectomy to ensure surgical margins

BMC Pulm Med. 2025 Jul 2;25(1):305. doi: 10.1186/s12890-025-03762-2.

Abstract

Background: Sublobectomy is one of the standard surgical procedures for early stage lung cancer. The distance of resection margin is the basic demand of sublobectomy. Therefore, it is of great clinical significance to ensure the margin distance in sublobectomy. How to ensure the margin distance in sublobectomy is still a difficult problem for thoracic surgeons. Our center has recently adopted the CT-guided medical adhesive localization method to solve the problem of insufficient lung margins with excellent results.

Methods: The clinical data of 40 patients with pulmonary nodules, who received VATS-based sublobectomy during the period from January 2022 to February 2023 in the Department of Thoracic Surgery, Juxian People's Hospital, Shandong Province, were retrospectively analyzed. All the patients underwent CT-guided lung puncture for medical adhesive-based pulmonary nodule localization before surgery. After resection, the distance between the pulmonary nodule and the surgical margin was measured, and the surgical margin was routinely sent for examination. The clinical case data of the patients were collected.

Results: All the 40 patients in the group successfully underwent percutaneous lung puncture for medical adhesive-based localization under local anesthesia. For all the patients, the distance between the lesion and the surgical margin was greater than 2 cm, and the surgical margin tested negative, with a localization success rate of 100%, and a localization duration of (15.0 ± 3.6) min. Localization complications included 2 cases of slight pneumothorax, 2 cases of bleeding along the needle tract, and 1 case of hemoptysis, none of which required special treatment.

Conclusion: CT-guided medical adhesive-based localization is a safe, effective and simple localization method, which has important clinical application value in ensuring the safety of surgical margins of pulmonary nodules and reducing the time needed to locate lesions during surgery.

Keywords: Intraoperative localization; Medical adhesive; Pulmonary ground-glass nodule; Sublobectomy; Surgical margin.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Male
  • Margins of Excision*
  • Middle Aged
  • Multiple Pulmonary Nodules* / diagnostic imaging
  • Multiple Pulmonary Nodules* / surgery
  • Pneumonectomy* / methods
  • Retrospective Studies
  • Solitary Pulmonary Nodule* / diagnostic imaging
  • Solitary Pulmonary Nodule* / surgery
  • Thoracic Surgery, Video-Assisted* / methods
  • Tomography, X-Ray Computed* / methods