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Intraoperative Longitude-Latitude-Depth Localization Versus Preoperative CT-Guided Percutaneous Lung Puncture Localization for 0.8-2 cm Peripheral Pulmonary Nodules

Sponsor: Qilu Hospital of Shandong University • ClinicalTrials.gov ID: NCT07675889

Registry updated: 2026-10-01

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Description

The goal of this clinical trial is to learn whether intraoperative longitude-latitude-depth three-dimensional localization (LLD localization) is non-inferior to preoperative CT-guided percutaneous lung puncture localization for identifying 0.8-2 cm peripheral pulmonary nodules in adults undergoing video-assisted thoracoscopic surgery (VATS)-assisted sublobar resection. It will also evaluate the safety and perioperative effectiveness of the two localization methods. The main questions it aims to answer are: 1. Is the localization accuracy rate of LLD localization non-inferior to that of CT-guided percutaneous lung puncture localization? 2. Does LLD localization improve perioperative outcomes, including localization time, postoperative recovery, pain, quality of life, and perioperative complication rates? Researchers will compare LLD localization with CT-guided percutaneous lung puncture localization to determine whether LLD localization provides comparable localization accuracy while reducing procedure-related complications and improving perioperative outcomes. Participants will: 1. Be randomly assigned in a 1:1 ratio to either the LLD localization group or the CT-guided percutaneous lung puncture localization group. 2. Undergo pulmonary nodule localization using the assigned localization method. 3. Receive VATS-assisted sublobar resection following localization. 4. Be assessed for localization accuracy, perioperative complications, localization time, postoperative chest drainage tube removal time, oxygenation index, postoperative hospital stay, pain scores, and quality-of-life outcomes. 5. Complete follow-up assessments at 1, 3, and 6 months after surgery.

Interventions

Longitude-Latitude-Depth Localization (Procedure)
The longitude-latitude-depth (LLD) localization method is a novel intraoperative three-dimensional pulmonary nodule localization technique developed for peripheral pulmonary nodules. Based on preoperative computed tomography (CT) imaging, the target lesion is characterized according to its longitudinal position, transverse position, and depth relative to the visceral pleural surface. During surgery, corresponding anatomical landmarks on the collapsed lung are identified, and the projected surface location and lesion depth are used to estimate the three-dimensional position of the target nodule. Localization is performed intraoperatively without preoperative transcutaneous puncture or placement of localization materials. The identified localization point is subsequently used to guide video-assisted thoracoscopic surgery (VATS)-assisted sublobar resection of the target lesion.
CT-Guided Percutaneous Lung Puncture Localization (Procedure)
CT-guided percutaneous lung puncture localization is a preoperative localization procedure performed under computed tomography guidance. A localization device is inserted through the chest wall into the lung parenchyma to mark the location of the target pulmonary nodule before surgery. Following localization, the position of the marker relative to the nodule is confirmed by CT imaging. The localization result is subsequently used to guide video-assisted thoracoscopic surgery (VATS)-assisted sublobar resection.

Eligibility criteria

Inclusion Criteria: * Clinically diagnosed pulmonary nodule by non-contrast chest CT. * Age 18 to 80 years. * Expected survival time of at least 12 months. * Single peripheral pulmonary nodule with a diameter between 0.8 cm and 2 cm. * Chest CT characteristics meeting both of the following criteria: 1. Solid component proportion ≤50%. 2. Located subpleurally or in the outer one-third of the lung parenchyma. * Willing to undergo VATS-assisted sublobar resection. * No contraindications to pulmonary localization procedures or surgery. * Able to understand the study and willing to sign written informed consent. Exclusion Criteria: * Use of other localization methods or other surgical procedures. * Concurrent participation in another clinical study. * Pregnancy. * Unwillingness or inability to cooperate with participation in this study for any reason.

Conditions

Pulmonary Nodule, Solitary Peripheral Pulmonary Nodules Pulmonary Nodules

Locations

Xingyi People's Hospital — Xingyi, Guizhou, China
Ningxia Hui Autonomous Region People's Hospital — Yinchuan, Ningxia, China
Qilu Hospital of Shandong University — Jinan, Shandong, China
Linqing People's Hospital — Linqing, Shandong, China

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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