Comparison between coil and hook-wire localization before video-assisted thoracoscopic surgery for lung nodules: a systematic review and meta-analysis

Introduction
Both coil and hook-wire localization techniques are commonly employed prior to video-assisted thoracic surgery (VATS) resection in patients with lung nodules (LNs), but the relative advantages of each remain uncertain.

Aim
This meta-analysis was performed to explore the relative safety and efficacy of coil localization (CL) and hook-wire localization (HWL) for patients with LNs.

Material and methods
The PubMed, Embase, Cochrane Library, Wanfang, and CINK databases were searched to identify relevant studies published as of February 2022, after which pooled analyses of study outcomes were conducted.

Results
In total, 8 studies met the inclusion criteria for the present meta-analysis. Successful localization rates were higher for the CL group relative to the HWL group (p = 0.0001). The CL group additionally exhibited significantly lower pooled total complication, pneumothorax, and lung hemorrhage rates relative to the HWL group (p = 0.01, p = 0.0001, p = 0.0009). Pooled duration of localization, VATS procedure duration, and wedge resection duration values were comparable in both groups (p = 0.69, p = 0.16, p = 0.76), as were chest pain scores (p = 0.06). When specifically analyzing the subset of patients with ground-glass LNs, pooled pneumothorax rates were significantly lower in the CL group relative to the HWL group (p = 0.03). Significant publication bias was detected with respect to rates of lung hemorrhage (Egger test, p = 0.029), but was not evident for other analyzed variables.

Conclusions
These results suggest that the coil-based localization of LNs before VATS resection is safer and more effective than hook-wire localization.