Intraoperative model-guided anchor placement with CT verification for non-percutaneous localization of small pulmonary nodules: a retrospective feasibility study
- 1Peking University First Hospital
Abstract
Background: Accurate localization of small pulmonary nodules, particularly ground-glass-dominant and deep lesions, remains challenging in thoracoscopic surgery. We evaluated a model-guided, non-percutaneous approach to intraoperative localization.
Method: We retrospectively reviewed consecutive patients who underwent intraoperative model-guided anchor-based non-percutaneous localization or conventional preoperative CT-guided puncture localization and resection for small pulmonary nodules at our center between January 1 and December 31, 2024. Localization-specific and perioperative outcomes were compared between groups.
Results: Twenty-four patients underwent intraoperative localization, and 91 underwent preoperative puncture localization. Median localization time with the intraoperative approach was 35.7 minutes (IQR 28.8-47.3 minutes). The observed localization-category distributions were similar between groups (precise: 50% vs. 49.49%; helpful: 43.33% vs. 42.42%; missed: 6.67% vs. 8.08%; p = 1.000). In this indication-selected cohort, intraparenchymal hemorrhage (0% vs. 16.16%, p = 0.022) and pneumothorax (0% vs. 31.87%, p < 0.001) were observed less frequently in the intraoperative group. All patients in the intraoperative-localization group subsequently underwent CONSERVO electroresection, whereas the conventional group underwent stapler-based resection. The combined intraoperative localization/CONSERVO strategy was associated with a shorter incision length but a longer non-localization operative time, greater blood loss, a longer chest-tube duration, and greater early drainage. Because localization and resection techniques differed concurrently, their independent contributions could not be determined.
Conclusion: Intraoperative model-guided anchor placement with CT verification was technically feasible in this small retrospective cohort. The approach avoided transthoracic puncture and may warrant further evaluation for selected patients with multiple nodules or lesions unsuitable for preoperative puncture or direct tactile localization.
Related
- Intraoperative Very High-Frequency Activity for Localization of the Epileptogenic Zone: An International Multicenter Study
- Computed tomography-guided percutaneous puncture injection of methylene blue mixed with autologous blood for preoperative localization of pulmonary nodules: analysis of 407 cases
- Feasibility and Safety of Intraoperative Abdominal Warming During Spinal Surgery in the Prone Position: A Pilot Study
- Anchored Drill-Assisted Localization for Percutaneous Endoscopic Cervical Keyhole Surgery in the Treatment of Cervical Spondylotic Radiculopathy: A Technical Report and Preliminary Efficacy Evaluation
- Intraoperative recall of surgeon-defined 3-dimensional planning during robotic pulmonary resection: A feasibility study
BibTeX
@article{zhang2026intraoperative,
title = {{Intraoperative model-guided anchor placement with CT verification for non-percutaneous localization of small pulmonary nodules: a retrospective feasibility study}},
author = {Xining Zhang and Jingwei Liu and Shijie Zhang and Jian Li},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1941071},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1941071/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Intraoperative model-guided anchor placement with CT verification for non-percutaneous localization of small pulmonary nodules: a retrospective feasibility study
AU - Xining Zhang
AU - Jingwei Liu
AU - Shijie Zhang
AU - Jian Li
PY - 2026
DA - 2026/10/19
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1941071
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1941071/full
AB - Background: Accurate localization of small pulmonary nodules, particularly ground-glass-dominant and deep lesions, remains challenging in thoracoscopic surgery. We evaluated a model-guided, non-percutaneous approach to intraoperative localization. Method: We retrospectively reviewed consecutive patients who underwent intraoperative model-guided anchor-based non-percutaneous localization or conventional preoperative CT-guided puncture localization and resection for small pulmonary nodules at our center between January 1 and December 31, 2024. Localization-specific and perioperative outcomes were compared between groups. Results: Twenty-four patients underwent intraoperative localization, and 91 underwent preoperative puncture localization. Median localization time with the intraoperative approach was 35.7 minutes (IQR 28.8-47.3 minutes). The observed localization-category distributions were similar between groups (precise: 50% vs. 49.49%; helpful: 43.33% vs. 42.42%; missed: 6.67% vs. 8.08%; p = 1.000). In this indication-selected cohort, intraparenchymal hemorrhage (0% vs. 16.16%, p = 0.022) and pneumothorax (0% vs. 31.87%, p < 0.001) were observed less frequently in the intraoperative group. All patients in the intraoperative-localization group subsequently underwent CONSERVO electroresection, whereas the conventional group underwent stapler-based resection. The combined intraoperative localization/CONSERVO strategy was associated with a shorter incision length but a longer non-localization operative time, greater blood loss, a longer chest-tube duration, and greater early drainage. Because localization and resection techniques differed concurrently, their independent contributions could not be determined. Conclusion: Intraoperative model-guided anchor placement with CT verification was technically feasible in this small retrospective cohort. The approach avoided transthoracic puncture and may warrant further evaluation for selected patients with multiple nodules or lesions unsuitable for preoperative puncture or direct tactile localization.
SN - 2234-943X
ER -