Comparative performance of marking of small-diameter peripheral lung neoplasms by preoperative transthoracic use of methylene blue preparations and placement of an anchor marker system

The study compared marking of small-diameter peripheral lung neoplasms by preoperative transthoracic use of 1% aqueous methylene blue solution and placement of an anchor marker system. The study evaluated the results of treatment of 36 patients with pulmonary nodules, including 27 men and 9 women aged 52 to 76 years, who were examined and treated at the Surgical Clinic of the S.M. Kirov Military Medical Academy in 2020-2023. Marking of small-diameter peripheral lung neoplasms by transthoracic use of 1% aqueous methylene blue solution made possible to detect abnormalities and lesions and perform a biopsy in 73.3% of cases. The duration of the diagnostic procedures was 30 [20-40] minutes. No postoperative complications were reported. The mean length of stay in this group of patients was 8 [6; 12] patient days. Placement of an anchor marker system allowed detection and verification of lung lesions in 95% of cases. In addition, the duration of videothoracoscopic biopsies was also 30 [20-40] minutes. No complications or deaths were reported. The mean length of stay was 7 [5; 11] patient days. The use of anchor markers to label small peripheral pulmonary nodules in the preoperative phase has some significant advantages compared with dye injection techniques, such as shorter duration of lesion mapping (p = 0.046) and less manipulation complications (p = 0.04), as well as a higher frequency of lesion detection during minimally invasive procedures. When comparing various techniques for marking pulmonary lesions, it was found that mapping of small-diameter peripheral pulmonary infiltrates using anchor markers is characterized by high performance, greater safety, facilitates intraoperative navigation for biopsy of small-diameter peripheral pulmonary neoplasms, and is superior than transthoracic use of 1% aqueous methylene blue in terms of rates of detection of pulmonary nodules during minimally invasive procedures, duration of manipulation, and complication rates.