{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:34:44Z","timestamp":1753893284501,"version":"3.41.2"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"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. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Video-assisted thoracoscopic surgery is a widely employed minimally invasive approach for resecting pulmonary nodules. However, precisely localizing deep-seated or poorly visualized nodules remains a prominent challenge. This study aims to compare the effectiveness and safety of medical glue vs. hook-wire in the CT-guided localization of multiple pulmonary nodules.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort of patients scheduled for CT-guided localization of multiple pulmonary nodules between February 2024 and August 2024 was enrolled. Patients were randomized into a medical glue group and a hook-wire group in a 1:1 ratio. The primary endpoint was the localization success rate, with the objective of conducting a non-inferiority comparison of medical glue and hook-wire for the preoperative localization of multiple pulmonary nodules at a non-inferiority margin of 10%. Secondary endpoints consisted of complication incidence following localization and pain scores assessed via the Numerical Rating Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Medical glue demonstrated non-inferior success rates vs. hook-wire [97.5% vs. 95%, absolute difference\u2009=\u20092.5%, 95% CI (\u22125.82%, 10.82%); <jats:italic>P<\/jats:italic>\u2009=\u20091.00]. Although overall complications were comparable (42.5% vs. 55.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.263), medical glue significantly reduced pneumothorax (22.5% vs. 47.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.019) and pulmonary hemorrhage (7.5% vs. 27.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.019). Patients receiving medical glue reported lower 2\u2005h pain scores (2.70\u2009\u00b1\u20090.76 vs. 3.71\u2009\u00b1\u20091.42, <jats:italic>P<\/jats:italic>\u2009=\u20090.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The application of medical glue for the CT-guided localization of multiple pulmonary nodules demonstrated a non-inferior success rate comparable to that of hook-wire. Furthermore, compared to hook-wire, medical glue was associated with a lower incidence of pneumothorax and pulmonary hemorrhage, as well as reduced pain scores at 2\u2005h post-localization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.chictr.org.cn<\/jats:uri>, identifier (ChiCTR2400080040).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1575698","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T05:13:11Z","timestamp":1744348391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-inferiority comparison of medical glue and hook-wire for preoperative localization of multiple pulmonary nodules"],"prefix":"10.3389","volume":"12","author":[{"given":"Zexin","family":"Xie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingsong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kewei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1200\/JCO.2012.43.3110","article-title":"Computed tomography screening for lung cancer: has it finally arrived? 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