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Background <p>Lung cancer affects millions of people annually, and while many nodules are resectable, some are difficult to localize because of their small size or depth. CT-guided localization techniques, particularly hook-wire placement and dye marking, are commonly used to facilitate surgical identification of pulmonary nodules. This systematic review and meta-analysis compared the safety and perioperative outcomes of these two approaches.</p> Methods <p>PubMed Central, Cochrane, Scopus, Web of Science, and Ovid were searched from inception to May 2025 for comparative studies of hook-wire versus dye-based localization for pulmonary nodules.</p> Results <p>Ten studies were included. Hook-wire localization was associated with significantly higher risks of lung hemorrhage (RR = 2.48, 95% CI: [2.00, 3.07], <i>p</i> &lt; 0.0001), pneumothorax (RR = 1.64, 95% CI: [1.34, 2.01], <i>p</i> &lt; 0.0001), and overall complications (RR = 1.87, 95% CI: [1.40, 2.51], <i>p</i> &lt; 0.0001) than dye localization. No statistically significant differences were found in localization procedure time (MD = 0.86&#xa0;min, 95% CI: [-1.29, 3.01], <i>p</i> = 0.4320), surgical duration (MD = 2.12&#xa0;min, 95% CI: [-6.32, 10.56], <i>p</i> = 0.6228), or postoperative hospital stay (MD = 0.15 days, 95% CI: [-0.51, 0.81], <i>p</i> = 0.6520).</p> Conclusion <p>Both techniques appear technically feasible, but dye-based localization was associated with a more favorable safety profile than hook-wire localization. Time-related outcomes did not differ significantly between approaches.</p>

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A Comparison Between Tissue Dyes and Hook-Wire Techniques for Pulmonary Nodule Localization: a Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年5月14日

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  • Nouran Nagy,
  • Mohamed Wagdy,
  • Peter Atef,
  • Ahmed M. Salah,
  • Hadeer Ahmed hashem,
  • Mostafa Mohamed Abdelmoneam Elsawy

摘要

Background

Lung cancer affects millions of people annually, and while many nodules are resectable, some are difficult to localize because of their small size or depth. CT-guided localization techniques, particularly hook-wire placement and dye marking, are commonly used to facilitate surgical identification of pulmonary nodules. This systematic review and meta-analysis compared the safety and perioperative outcomes of these two approaches.

Methods

PubMed Central, Cochrane, Scopus, Web of Science, and Ovid were searched from inception to May 2025 for comparative studies of hook-wire versus dye-based localization for pulmonary nodules.

Results

Ten studies were included. Hook-wire localization was associated with significantly higher risks of lung hemorrhage (RR = 2.48, 95% CI: [2.00, 3.07], p < 0.0001), pneumothorax (RR = 1.64, 95% CI: [1.34, 2.01], p < 0.0001), and overall complications (RR = 1.87, 95% CI: [1.40, 2.51], p < 0.0001) than dye localization. No statistically significant differences were found in localization procedure time (MD = 0.86 min, 95% CI: [-1.29, 3.01], p = 0.4320), surgical duration (MD = 2.12 min, 95% CI: [-6.32, 10.56], p = 0.6228), or postoperative hospital stay (MD = 0.15 days, 95% CI: [-0.51, 0.81], p = 0.6520).

Conclusion

Both techniques appear technically feasible, but dye-based localization was associated with a more favorable safety profile than hook-wire localization. Time-related outcomes did not differ significantly between approaches.