Abstract:Objective To investigate the safety, feasibility and effectiveness of preoperative CT-guided localization for small pulmonary nodule （SPNs） with a mixture of cyanoacrylate and methylene blue. Methods A retrospective study was performed on 162 patients （with 167 SPNs） admitted to Nanjing Jiangning Hospital from May 2020 to May 2021,who received CT-guided percutaneous location of cyanoacrylate and methylene blue before video-assisted thoracoscopic surgery （VATS）. Results All 167 nodules in 162 patients were successfully marked before operation, and the time required for localization was （10.72±3.19） min. There were no severe complications such as allergy, embolism, displacement or dislocation during the positioning process. Out of 38 cases （23.46%） with local localization-related complications, there were 24 cases of pneumothorax, 10 cases of intrapulmonary hemorrhage and 8 cases of some glue for localization expelled from the trachea by coughing （including 4 cases of pneumothorax combined with intrapulmonary hemorrhage）. No cases needed with clinical intervention. All nodules were successfully resected under VATS the next day of localization, and there were no related delayed complications after operation. Conclusion Preoperative CT-guided localization of cyanoacrylate combined with methylene blue is a simple, safe and feasible method for the patients with SPNs undergoing VATS.