{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:07:18Z","timestamp":1781914038557,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Preoperative localization for small invisible and impalpable pulmonary nodules is important in single-port video-assisted thoracoscopic surgery (VATS). Localization of multiple pulmonary nodules during VATS resection remains challenging. The aim of our study is to elucidate the efficacy of preoperative CT-guided methylene blue localization of both single and multiple pulmonary nodules.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Consecutive patients undergoing preoperative CT-guided methylene blue dye localization for lung nodules, followed by VATS resection, were retrospectively analyzed between January 2014 and November 2019. Chi-square tests, Fisher's exact test and independent <jats:italic>T-<\/jats:italic>test were used to compare variables between the groups. Logistic regression was used to identify risk factors for procedure-related complications.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 388 patients, including 337 with single nodule and 51 with multiple nodules, were analyzed. The success rate of preoperative CT-guided methylene blue localization for both single and multiple pulmonary nodules were comparable as 98.8% (333\/337) vs. 100% (108\/108). The procedure time was longer (23.2 \u00b1 9.4 vs. 7.6 \u00b1 4.8 min, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and risk of pneumothorax was higher (47.1 vs. 25.5%, <jats:italic>p<\/jats:italic> = 0.002) in the multiple nodule group. The procedure time (OR 1.079; 95% CI = 1.041\u20131.118; <jats:italic>p<\/jats:italic> &amp;lt; 0.001) was an independent risk factor for pneumothorax. Nodule depth (OR 2.829; 95% CI = 1.259\u20136.356; <jats:italic>p<\/jats:italic> = 0.011) was an independent risk factor for pulmonary hemorrhage.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Preoperative CT-guided methylene blue localization for both single and multiple pulmonary nodules is safe, feasible, and effective.<\/jats:p>","DOI":"10.3389\/fmed.2021.661956","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T04:32:03Z","timestamp":1618374723000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Computed Tomography-Guided Methylene Blue Localization: Single vs. Multiple Lung 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