Objective:

To evaluate the accuracy and safety of indocyanine green (ICG) staining combined with electromagnetic navigation bronchoscopy (ENB) compared to hook-wire percutaneous localization for pulmonary nodules near the fissures, emphasizing the comparative nature of the study.

Key Findings:

• ENB group required more localization time than hook-wire group (25.30 min vs. 19.68 min, P < 0.05), highlighting the trade-off between time and safety. Only 3.0% of ENB cases required further resection compared to 22.6% in the hook-wire group (P = 0.018), indicating a significant difference in resection needs. Pneumothorax incidence was significantly lower in the ENB group (6.10% vs. 25.80%, P = 0.03), underscoring the safety profile of ENB.

Interpretation:

ENB combined with ICG staining significantly reduces the likelihood of extended resection and has a higher safety profile compared to hook-wire localization, suggesting a potential shift in clinical practice.

Limitations:

• Retrospective design may introduce selection bias and small sample size may limit generalizability of findings; potential biases in data collection or analysis should also be acknowledged.

Conclusion:

ENB with ICG staining is a safer and more effective method for localizing pulmonary nodules near fissures compared to hook-wire localization, reinforcing the need for further studies to validate these findings.