Preoperative localization for pulmonary nodules: a meta-analysis of coil and liquid materials.

PURPOSE: This study was designed to conduct pooled comparisons of the relative clinical efficacy and safety of computed tomography (CT)-guided localization for pulmonary nodules (PNs) using either coil- or liquid material-based approaches. MATERIAL AND METHODS: Relevant articles published as of July 2023 were identified in the Web of Science, PubMed, and Wanfang databases, and pooled analyses of relevant endpoints were then conducted. RESULTS: Six articles that enrolled 287 patients (341 PNs) and 247 patients (301 PNs) that had respectively undergone CT-guided localization procedures using coil- and liquid material-based approaches prior to video-assisted thoracic surgery (VATS) were included in this meta-analysis. The liquid material group exhibited a significantly higher pooled successful localization rate as compared to the coil group (p = 0.01), together with significantly lower pooled total complication rates (p = 0.0008) and pneumothorax rates (p = 0.01). Both groups exhibited similar rates of pulmonary hemorrhage (p = 0.44) and successful wedge resection (p = 0.26). Liquid-based localization was also associated with significant reductions in pooled localization and VATS procedure durations (p = 0.004 and 0.007). CONCLUSIONS: These data are consistent with CT-guided localization procedures performed using liquid materials being safer and more efficacious than coil-based localization in patients with PNs prior to VATS resection.

Radioactive and normal stent insertion for the treatment of malignant airway stenosis: A meta-analysis.

PURPOSE: To demonstrate the advantage of radioactive stent (RS) for treating malignant airway stenosis (MAS) in reducing the stent restenosis rate and increasing overall survival (OS). MATERIALS AND METHODS: Relevant studies in Pubmed, Embase, and Cochrane Library databases were identified. The rate of stent restenosis was the primary endpoint, whereas secondary endpoints were rates of stent-related complications, OS, and complete relief of dyspnea. This meta-analysis was conducted using RevMan v5.3. RESULTS: Five total studies including 131 and 119 patients that underwent RS and normal stent (NS) insertion, respectively, were identified and included in this meta-analysis. Four studies were randomized controlled trials and one study was retrospective study. Pooled rates of complete relief of dyspnea, chest pain, hemoptysis, and fistula formation were similar between these two groups (p = 0.72, 0.77, 0.92, and 0.62, respectively). Pooled Δstenosis grade was comparable between these two groups (p = 0.72). RS insertion was linked to a significant lower pooled stent restenosis rate, increased OS, and higher 3-month survival rate relative to NS insertion (p< 0.00001, 0.0001, and 0.03, respectively). Pooled 6-months survival rates was higher in RS group without significant difference (p = 0.06). Pooled stent restenosis rate was significant higher in RS group based on each subgroup analysis. No evidence of publication bias for these endpoints was detected via funnel plot. CONCLUSIONS: This meta-analysis revealed that RS insertion was sufficient to reduce rates of stent restenosis and to prolong patient OS relative to NS insertion when used to treat MAS.